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General NPI Number Information
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NPI Number | 1679903256
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Entity Type | Organization
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Legal Business Name | SUPPORTIVE AND BEHAVIORAL COUNSELING OF LAS VEGAS, LLC
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 1650 E SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89104-3494
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Country | US
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Telephone | 702-917-2705
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Fax | 775-372-6126
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Provider Business Mailing Address
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Address Line | 1650 E SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89104-3494
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Country | US
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Telephone | 702-917-2705
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Fax | 775-372-6126
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Authorized Official
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Title or Position | CEO
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Name | SONIA LOPEZ
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Credential | M.A.
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Telephone | 209-596-6339
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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 |
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License Number State | NV
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