MEDICARE: ORION BLOCK LSW

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	1062-S	NV
2	390200000X	Student in an Organized Health Care Education/Training Program		CA
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1063948966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORION BLOCK LSW

Provider Business Mailing Address
First Line	:	5915 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2557
Country	:	US
Telephone Number	:	702-903-2677
Fax Number	:

Provider Business Practice Location Address
First Line	:	5915 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2557
Country	:	US
Telephone Number	:	702-209-0730
Fax Number	:

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	02/27/2025

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Directions to “ ORION BLOCK LSW” Practice Location

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