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NPI Code Detail

MEDICARE: JACLYN HAIEM M.ED. & CPC-I

MEDICARE:   JACLYN  HAIEM  M.ED. & CPC-I
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1104574854
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYN HAIEM M.ED. & CPC-I
Provider Business Mailing Address
First Line : 11717 VIA ESPERANZA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-6023
Country : US
Telephone Number : 484-358-5387
Fax Number :
Provider Business Practice Location Address
First Line : 3890 W ANN RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4416
Country : US
Telephone Number : 702-287-8895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2022
Last Update Date : 03/15/2022

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Directions to “ JACLYN HAIEM M.ED. & CPC-I” Practice Location

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