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General NPI Number Information
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NPI Number | 1083181481
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Entity Type | Individual
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Provider Name | NICOLE MARIE BURCHETT MFT-STUDENT
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Gender | Female
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 7473 W. LAKE MEAD BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89128
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Country | US
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Telephone | 702-670-0043
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Fax | 702-973-7373
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Provider Business Mailing Address
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Address Line | 1848 DEL MONICO WAY
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031
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Country | US
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Telephone | 702-355-6555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | NV
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