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General NPI Number Information
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NPI Number | 1215212501
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Entity Type | Organization
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Legal Business Name | CHILDREN & FAMILY COUNSELING, LLC
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 35 N WEST ST
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City | FERNLEY
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State | NV
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Zip | 89408-7671
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Country | US
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Telephone | 775-575-4141
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Fax | 775-575-4140
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Provider Business Mailing Address
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Address Line | 35 N WEST ST
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City | FERNLEY
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State | NV
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Zip | 89408-7671
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Country | US
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Telephone | 775-575-4141
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Fax | 775-575-4140
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY WILLIAM DAVIS
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Credential | MSW,LCSW
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Telephone | 775-575-4141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4835-C
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License Number State | NV
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