Healthcare Provider Details

I. General information

NPI: 1225656788
Provider Name (Legal Business Name): MRS. DARBY MERCEDES SAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. DARBY MERCEDES SAMS

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 REGATTA DR STE 102
LAS VEGAS NV
89128-6892
US

IV. Provider business mailing address

9812 TWIN MILL ST
LAS VEGAS NV
89178-4868
US

V. Phone/Fax

Practice location:
  • Phone: 725-222-0101
  • Fax:
Mailing address:
  • Phone: 702-672-7079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMI4548
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: