MEDICARE: MS. MIRIAN I. FERREIRA 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	101YM0800X	Mental Health Counselor	LCSW 4193-C	NV

General Provider Information

NPI Number	:	1093041246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MIRIAN I. FERREIRA LCSW

Provider Business Mailing Address
First Line	:	3514 SPRING VISTAS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-3702
Country	:	US
Telephone Number	:	702-217-3301
Fax Number	:

Provider Business Practice Location Address
First Line	:	3514 SPRING VISTAS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-3702
Country	:	US
Telephone Number	:	702-217-3301
Fax Number	:

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

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	10/22/2009

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