MEDICARE: MARIA PAXINOS 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	4452-C	NV

General Provider Information

NPI Number	:	1194047696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA PAXINOS LCSW

Provider Business Mailing Address
First Line	:	4794 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6145
Country	:	US
Telephone Number	:	702-732-0304
Fax Number	:	702-794-2033

Provider Business Practice Location Address
First Line	:	4794 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6145
Country	:	US
Telephone Number	:	702-732-0304
Fax Number	:	702-794-2033

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

Provider Enumeration Date	:	02/24/2010
Last Update Date	:	11/15/2012

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