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General NPI Number Information
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NPI Number | 1992145692
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Entity Type | Organization
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Legal Business Name | BUDDHIST PSYCHOTHERAPY INSTITUTE LLC
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 911 N BUFFALO DR UNIT 208
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City | LAS VEGAS
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State | NV
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Zip | 89128-0381
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Country | US
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Telephone | 702-489-8645
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Fax | 702-475-4104
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Provider Business Mailing Address
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Address Line | 805 MERIALDO LN
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City | LAS VEGAS
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State | NV
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Zip | 89145-4827
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Country | US
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Telephone | 702-489-8645
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Fax | 702-475-4104
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Authorized Official
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Title or Position | OWNER, CLINICAL DIRECTOR
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Name | CHRISTINE ACKMANN
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Credential | LCSW
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Telephone | 702-489-8645
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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 | 5553-C
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License Number State | NV
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