Healthcare Provider Details

I. General information

NPI: 1457411738
Provider Name (Legal Business Name): JANICE A EAMES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 N WILLOW ST SUITE 4
MESQUITE NV
89027-4785
US

IV. Provider business mailing address

4126 TECHNOLOGY WAY SUITE 102
CARSON CITY NV
89706-2009
US

V. Phone/Fax

Practice location:
  • Phone: 702-346-4696
  • Fax: 702-346-4699
Mailing address:
  • Phone: 775-687-7573
  • Fax: 775-687-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4973-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: