MEDICARE: MAIKWE LINDA PARSONS L.C.S.W.

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	0414-C	NV

General Provider Information

NPI Number	:	1124324215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAIKWE LINDA PARSONS L.C.S.W.

Provider Business Mailing Address
First Line	:	6698 STARSHELL BAY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6113
Country	:	US
Telephone Number	:	702-321-7567
Fax Number	:	702-534-4037

Provider Business Practice Location Address
First Line	:	5145 S DURANGO DR
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-0191
Country	:	US
Telephone Number	:	702-321-7567
Fax Number	:	702-534-4037

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

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	02/07/2011

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