Healthcare Provider Details

I. General information

NPI: 1346992872
Provider Name (Legal Business Name): VERNITA CATHERINE BEACH LMSW, CSW-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

4204 BUTEO LN
NORTH LAS VEGAS NV
89084-3507
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9314
  • Fax:
Mailing address:
  • Phone: 850-900-7488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6121G
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33011199A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9710-M
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-1904
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: