Healthcare Provider Details

I. General information

NPI: 1629309208
Provider Name (Legal Business Name): ERICKA L SEVERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 W CRAIG RD STE A
NORTH LAS VEGAS NV
89032-5116
US

IV. Provider business mailing address

3435 W CRAIG RD STE A
NORTH LAS VEGAS NV
89032-5116
US

V. Phone/Fax

Practice location:
  • Phone: 702-675-6314
  • Fax: 702-476-9697
Mailing address:
  • Phone: 702-675-6314
  • Fax: 702-476-9697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5901-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: