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NPI Code Detail

MEDICARE: JUDITH CARON LCSW

MEDICARE: JUDITH CARON 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
11041C0700XClinical Social Worker7271571ID
21041C0700XClinical Social Worker10806-CNV

General Provider Information

NPI Number : 1114266095
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH CARON LCSW
Provider Business Mailing Address
First Line : 3890 W ANN RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4416
Country : US
Telephone Number : 702-518-0229
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 : 702-518-0229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2013
Last Update Date : 09/18/2025

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