MEDICARE: MR. NICHOLAS L NEUBAUER M.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		NV

General Provider Information

NPI Number	:	1265661946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS L NEUBAUER M.S.W.

Provider Business Mailing Address
First Line	:	2313 SUNRISE MEADOWS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6926
Country	:	US
Telephone Number	:	702-806-5268
Fax Number	:	702-222-3275

Provider Business Practice Location Address
First Line	:	6402 MCLEOD DR
Second Line	:	SUITE #5
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4405
Country	:	US
Telephone Number	:	702-898-5311
Fax Number	:	702-222-3275

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

Provider Enumeration Date	:	07/02/2009
Last Update Date	:	07/02/2009

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