Healthcare Provider Details

I. General information

NPI: 1215340864
Provider Name (Legal Business Name): DONALD POSSON PH.D., LADC, BCN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 S VALLEY VIEW BLVD STE 4
LAS VEGAS NV
89102-0116
US

IV. Provider business mailing address

2801 S VALLEY VIEW BLVD STE 4
LAS VEGAS NV
89102-0116
US

V. Phone/Fax

Practice location:
  • Phone: 702-684-1455
  • Fax:
Mailing address:
  • Phone: 702-684-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License NumberE6050
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1082
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: