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General NPI Number Information
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NPI Number | 1770138653
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Entity Type | Organization
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Legal Business Name | NIRVANA COUNSELING (KANOZA), PLLC
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 4580 S EASTERN AVE STE 33
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City | LAS VEGAS
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State | NV
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Zip | 89119-6100
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Country | US
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Telephone | 702-329-4937
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Fax |
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Provider Business Mailing Address
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Address Line | 17 REYBURN DR
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City | HENDERSON
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State | NV
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Zip | 89074-3347
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | KAVITA KANOZA
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Credential |
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Telephone | 702-329-4937
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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 |
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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 |
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License Number State |
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