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General NPI Number Information
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NPI Number | 1255958799
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Entity Type | Individual
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Provider Name | JOSEPH PATRICK MINNICK JR. LMSW, CADC,CSW-I
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Gender | Male
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 1065 E FLAMINGO RD APT 722
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City | LAS VEGAS
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State | NV
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Zip | 89119-7453
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Country | US
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Telephone | 170-227-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 1065 E FLAMINGO RD APT 722
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City | LAS VEGAS
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State | NV
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Zip | 89119-7453
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Country | US
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Telephone | 702-275-7227
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 07761-C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IC-2890
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4160-S
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License Number State | NV
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