MEDICARE: GEOARGINA BILLINGSLEY MSW

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	6523-S	NV

General Provider Information

NPI Number	:	1093360729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEOARGINA BILLINGSLEY MSW

Provider Business Mailing Address
First Line	:	8275 SKYE GORGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-1205
Country	:	US
Telephone Number	:	702-823-9587
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 W CHARLESTON BLVD STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1067
Country	:	US
Telephone Number	:	702-437-4673
Fax Number	:	702-437-4673

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

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	08/08/2019

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