Healthcare Provider Details

I. General information

NPI: 1033640719
Provider Name (Legal Business Name): PSYCHOLOGICAL SOLUTIONS FOR NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 09/06/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3175 E WARM SPRINGS RD STE 105
LAS VEGAS NV
89120-3137
US

IV. Provider business mailing address

3175 E WARM SPRINGS RD STE 105
LAS VEGAS NV
89120-3137
US

V. Phone/Fax

Practice location:
  • Phone: 27-506-4089
  • Fax:
Mailing address:
  • Phone: 702-506-4089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY06677
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPY06677
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPY06677
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY06677
License Number StateNV

VIII. Authorized Official

Name: DR. BREE MULLIN
Title or Position: OWNER
Credential: PSYD
Phone: 702-506-4089