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General NPI Number Information
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NPI Number | 1336727106
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Entity Type | Individual
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Provider Name | ASHLY GOMEZ-HETHERMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 3016 W CHARLESTON BLVD STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89102-1964
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Country | US
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Telephone | 702-412-9077
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Fax |
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Provider Business Mailing Address
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Address Line | 1917 TOSCANINI WAY
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-0650
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Country | US
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Telephone | 702-339-2928
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 12206-C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12206-C
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License Number State | NV
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