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General NPI Number Information
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NPI Number | 1831395276
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Entity Type | Organization
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Legal Business Name | JOHN S. PACULT, LCSW, INC.
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 2980 S RAINBOW BLVD SUITE 210
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City | LAS VEGAS
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State | NV
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Zip | 89146-6531
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Country | US
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Telephone | 702-248-5456
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Fax | 702-889-4232
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Provider Business Mailing Address
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Address Line | 2980 S RAINBOW BLVD SUITE 210
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City | LAS VEGAS
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State | NV
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Zip | 89146-6531
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Country | US
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Telephone | 702-248-5456
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Fax | 702-889-4232
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. JOHN SEBASTIAN PACULT
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Credential | MSW, LCSW
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Telephone | 702-248-5456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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