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General NPI Number Information
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NPI Number | 1699158782
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Entity Type | Individual
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Provider Name | TATIANA LENGLE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 4700 LAS VEGAS BLVD N
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City | NELLIS AFB
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State | NV
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Zip | 89191-6600
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Country | US
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Telephone | 702-653-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 4660 S EASTERN AVE STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89119-6137
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Country | US
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Telephone | 702-451-7542
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Fax | 702-450-4239
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | IC-920
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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 | 149018522
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License Number State | IL
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