Healthcare Provider Details

I. General information

NPI: 1457765612
Provider Name (Legal Business Name): CAMELIA MAYFIELD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5460 W SAHARA AVE
LAS VEGAS NV
89146-3307
US

IV. Provider business mailing address

5460 W SAHARA AVE
LAS VEGAS NV
89146-3307
US

V. Phone/Fax

Practice location:
  • Phone: 702-216-8900
  • Fax:
Mailing address:
  • Phone: 702-216-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL10920
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12872-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: