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NPI Code Detail

MEDICARE: FDV WELLNESS CENTER

MEDICARE: FDV WELLNESS CENTER
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
2225400000XRehabilitation Practitioner
3106H00000XMarriage & Family Therapist
41041C0700XClinical Social Worker

General Provider Information

NPI Number : 1134813991
Entity Type Code : Organization
Provider Name (Legal Business Name) : FDV WELLNESS CENTER
Provider Business Mailing Address
First Line : 6402 MCLEOD DR STE 5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4406
Country : US
Telephone Number : 725-204-8809
Fax Number :
Provider Business Practice Location Address
First Line : 6402 MCLEOD DR STE 5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4406
Country : US
Telephone Number : 725-204-8809
Fax Number :
Authorized Official
Title or Position : COO
Name : PERLA SANCHEZ
Credential :
Telephone Number : 725-204-8809
Provider Enumeration Date : 06/05/2023
Last Update Date : 01/20/2026

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1518496314 — MS. SARAH ALSHAIKH
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1972166759 — MELISA CELIS CADC-I
Practice Location Address:
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LAS VEGAS, NV
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1699331579 — ALEXIS KRISTINA LANE MSW
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Directions to “FDV WELLNESS CENTER ” Practice Location

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