Healthcare Provider Details

I. General information

NPI: 1720320443
Provider Name (Legal Business Name): MRS. LILLIAN AGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 W DESERT INN RD
LAS VEGAS NV
89146-6609
US

IV. Provider business mailing address

3130 S RAINBOW BLVD STE 304
LAS VEGAS NV
89146-6232
US

V. Phone/Fax

Practice location:
  • Phone: 702-406-6525
  • Fax:
Mailing address:
  • Phone: 702-202-3374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1760865919
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: