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General NPI Number Information
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NPI Number | 1336039569
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Entity Type | Individual
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Provider Name | MALEK R BAXTER
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Gender | Male
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 2881 S VALLEY VIEW BLVD STE 1
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City | LAS VEGAS
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State | NV
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Zip | 89102-0145
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Country | US
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Telephone | 702-922-7015
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Fax |
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Provider Business Mailing Address
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Address Line | 3364 CHEYENNE GARDENS WAY
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-8916
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Country | US
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Telephone | 702-906-9554
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CI5619
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License Number State | NV
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