Healthcare Provider Details

I. General information

NPI: 1427913508
Provider Name (Legal Business Name): LHC LCPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10446 FANCY FERN ST
LAS VEGAS NV
89183-5221
US

IV. Provider business mailing address

PO BOX 12542
LAS VEGAS NV
89112-0542
US

V. Phone/Fax

Practice location:
  • Phone: 818-267-6016
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRIA CLEVERLY
Title or Position: OWNER
Credential:
Phone: 818-267-6016