MEDICARE: NICOLE JAMES 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
1	1041C0700X	Clinical Social Worker	6870-C	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1174874101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE JAMES LCSW

Provider Business Mailing Address
First Line	:	8870 S MARYLAND PKWY STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4010
Country	:	US
Telephone Number	:	702-832-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	8870 S MARYLAND PKWY STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4010
Country	:	US
Telephone Number	:	702-505-3575
Fax Number	:

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

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	04/04/2019

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Directions to “ NICOLE JAMES LCSW” Practice Location

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