NPI Code Details Logo

NPI 1790354082

NPI 1790354082 : NORTHERN NEVADA MENTAL HEALTH AND SUBSTANCE ABUSE, PLLC : RENO, NV

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1790354082
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    NORTHERN NEVADA MENTAL HEALTH AND SUBSTANCE ABUSE, PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/21/2021
-----------------------------------------------------
    Last Update Date     |    11/15/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    150 COUNTRY ESTATES CIR STE 105 
-----------------------------------------------------
    City                 |    RENO
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89511-4017
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    775-544-6966
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    150 COUNTRY ESTATES CIR STE 105 
-----------------------------------------------------
    City                 |    RENO
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89511-4017
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    775-544-6966
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     BRIAN P CRANE 
-----------------------------------------------------
    Credential           |    LCSW
-----------------------------------------------------
    Telephone            |    775-544-6966
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.