MEDICARE: TOUGH LOVE COUNSELING SERVICES, LLC

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	7370-C	NV

General Provider Information

NPI Number	:	1205375086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOUGH LOVE COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	6337 STERLING RANCH WAY
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89081-6713
Country	:	US
Telephone Number	:	702-287-8895
Fax Number	:	702-952-5442

Provider Business Practice Location Address
First Line	:	3890 W ANN RD STE 108
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4417
Country	:	US
Telephone Number	:	702-287-8895
Fax Number	:	702-952-5442

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	ASHLEY COLEMAN
Credential	:
Telephone Number	:	702-287-8895

Provider Enumeration Date	:	02/14/2017
Last Update Date	:	11/10/2022

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