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General NPI Number Information
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NPI Number | 1922313188
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Entity Type | Individual
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Provider Name | DONALD MICHAEL JAMES CADC, NCACII,CADCII
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Gender | Male
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 6628 SKY POINTE DR SUITE 102
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City | LAS VEGAS
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State | NV
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Zip | 89131-4070
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Country | US
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Telephone | 702-533-6260
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Fax | 800-934-3180
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Provider Business Mailing Address
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Address Line | 6628 SKY POINTE SUITE 102
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City | LAS VEGAS
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State | NV
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Zip | 89131
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Country | US
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Telephone | 702-533-6260
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Fax | 800-934-3180
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CADC 00213-C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | NCACII 015096
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CADCII 09-R-20
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License Number State | OR
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