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General NPI Number Information
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NPI Number | 1851535520
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Entity Type | Individual
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Provider Name | AISHIA GREVENBERG LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 5154 S DURANGO DR STE 103
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City | LAS VEGAS
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State | NV
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Zip | 89113-3171
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Country | US
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Telephone | 702-523-5226
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Fax | 702-834-4871
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Provider Business Mailing Address
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Address Line | 33 DELIGHTED AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-1393
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Country | US
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Telephone | 702-523-5226
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Fax | 702-834-4871
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4661-S
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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 | 6121-C
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6121-C
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License Number State | NV
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