Healthcare Provider Details

I. General information

NPI: 1295178101
Provider Name (Legal Business Name): CHARLES ANTHONY MROZEK LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6171 W CHARLESTON BLVD BLDG 17
LAS VEGAS NV
89146-1126
US

IV. Provider business mailing address

6171 W CHARLESTON BLVD BLDG 17
LAS VEGAS NV
89146-1126
US

V. Phone/Fax

Practice location:
  • Phone: 27-343-9224
  • Fax:
Mailing address:
  • Phone: 702-343-9224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCP0138
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: