Healthcare Provider Details

I. General information

NPI: 1285269100
Provider Name (Legal Business Name): THE PSYCHOLOGY INSTITUTE OF LAS VEGAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 S BUFFALO DR STE 120
LAS VEGAS NV
89117-2749
US

IV. Provider business mailing address

2451 S BUFFALO DR STE 120
LAS VEGAS NV
89117-2749
US

V. Phone/Fax

Practice location:
  • Phone: 702-546-9600
  • Fax:
Mailing address:
  • Phone: 702-546-9600
  • Fax: 702-829-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIELLE MOREGGI
Title or Position: OWNER
Credential: PHD
Phone: 702-546-9600