Healthcare Provider Details

I. General information

NPI: 1922560341
Provider Name (Legal Business Name): CHRISTINA PARISE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3097 E WARM SPRINGS RD STE 400
LAS VEGAS NV
89120-3757
US

IV. Provider business mailing address

1512 TWIN SPRINGS CT
HENDERSON NV
89014-0319
US

V. Phone/Fax

Practice location:
  • Phone: 702-582-6063
  • Fax: 702-825-0093
Mailing address:
  • Phone: 248-330-7511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA PARISE
Title or Position: OWNER
Credential: LCSW
Phone: 248-330-7511