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General NPI Number Information
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NPI Number | 1194273391
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Entity Type | Individual
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Provider Name | RYANJACOB PASCUAL MS, LPC-I
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Gender | Male
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 6871 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89117-1600
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Country | US
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Telephone | 702-489-2117
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Fax | 702-467-4767
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Provider Business Mailing Address
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Address Line | 6871 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89117-1600
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Country | US
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Telephone | 702-489-2117
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Fax | 702-467-4767
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CI2794
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License Number State | NV
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