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NPI Code Detail

MEDICARE: MISS LINDA FAYE CRUTCHER-AUSTIN COMMUNITY HEALTH WOR

MEDICARE: MISS LINDA FAYE CRUTCHER-AUSTIN COMMUNITY HEALTH WOR
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 CounselorCHW1-5416NV
2103K00000XBehavior AnalystNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114227907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LINDA FAYE CRUTCHER-AUSTIN COMMUNITY HEALTH WOR
Provider Business Mailing Address
First Line : 3624 RUSSIAN OLIVE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7643
Country : US
Telephone Number : 702-353-1079
Fax Number : 702-823-5905
Provider Business Practice Location Address
First Line : 3624 RUSSIAN OLIVE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7643
Country : US
Telephone Number : 702-534-8778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2010
Last Update Date : 04/08/2026

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