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General NPI Number Information
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NPI Number | 1932465507
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Entity Type | Organization
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Legal Business Name | ALENCASTRE COUNSELING, LLC
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Dates
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Enumeration Date | 04/07/2012
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Last Update Date | 03/30/2014
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Provider Practice Location Address
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Address Line | 9418 W LAKE MEAD BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89134-8312
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Country | US
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Telephone | 702-807-3082
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Fax | 702-445-6454
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Provider Business Mailing Address
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Address Line | 9418 W LAKE MEAD BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89134-8312
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Country | US
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Telephone | 702-807-3082
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Fax | 702-445-6454
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | KRISTIN KAKIUCHI
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Credential | M.S., M.F.T
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Telephone | 702-807-3082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 01184
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License Number State | NV
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