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General NPI Number Information
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NPI Number | 1982130787
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Entity Type | Organization
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Legal Business Name | IVY COUNSELING LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 810 S 7TH ST
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City | LAS VEGAS
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State | NV
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Zip | 89101-6910
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Country | US
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Telephone | 702-349-3328
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Fax |
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Provider Business Mailing Address
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Address Line | 810 S 7TH ST
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City | LAS VEGAS
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State | NV
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Zip | 89101-6910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER/COUNSELOR
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Name | MS. CHRISTINA M NAVARRO
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Credential |
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Telephone | 702-349-3328
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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 | 1271-L
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6751-S
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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