MEDICARE: MINERVA NILO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	112036	CA
2	1041C0700X	Clinical Social Worker	7062-C	NV

General Provider Information

NPI Number	:	1013158823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINERVA NILO LCSW

Provider Business Mailing Address
First Line	:	PO BOX 230831
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89105-0831
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	187 E WARM SPRINGS RD STE B157
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4110
Country	:	US
Telephone Number	:	702-899-1950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2009
Last Update Date	:	11/14/2024

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Directions to “ MINERVA NILO LCSW” Practice Location

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