MEDICARE: KADIE NASSI CPC

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	101YM0800X	Mental Health Counselor	MH25560	FL
2	101YP2500X	Professional Counselor	CI5089	NV

General Provider Information

NPI Number	:	1053976233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KADIE NASSI CPC

Provider Business Mailing Address
First Line	:	304 S JONES BLVD # 1007
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	702-706-2056
Fax Number	:

Provider Business Practice Location Address
First Line	:	2921 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1409
Country	:	US
Telephone Number	:	702-942-1774
Fax Number	:

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

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	03/09/2026

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Directions to “ KADIE NASSI CPC” Practice Location

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