=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073477238
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIANO CODARINI
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2025
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 522 E LAKE MEAD PKWY STE 2
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89015-5573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-900-5040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 522 E LAKE MEAD PKWY STE 2
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89015-5573
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-900-5040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 4465
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------