MEDICARE: MS. CHELSEA MARY PATOW 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	8167-C	NV

General Provider Information

NPI Number	:	1093089849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHELSEA MARY PATOW LCSW

Provider Business Mailing Address
First Line	:	3450 ERVA ST APT 135
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-6316
Country	:	US
Telephone Number	:	702-750-6225
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3144
Country	:	US
Telephone Number	:	702-750-6225
Fax Number	:	844-965-9650

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

Provider Enumeration Date	:	02/25/2012
Last Update Date	:	07/31/2020

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