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General NPI Number Information
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NPI Number | 1508550666
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Entity Type | Organization
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Legal Business Name | FLOURISH NEVADA COUNSELING AND WELLNESS PLLC
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 458 COURT ST STE 106
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City | RENO
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State | NV
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Zip | 89501-1709
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Country | US
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Telephone | 775-453-6841
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 LAKESIDE DR # 1231
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City | RENO
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State | NV
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Zip | 89509-4841
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Country | US
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Telephone | 775-453-6841
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. KAITLIND JOHNSON
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Credential | LCSW
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Telephone | 775-453-6841
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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 |
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License Number State |
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