MEDICARE: SIMONE CHERELL PHILLIPS MSW, 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	10969-C	NV

General Provider Information

NPI Number	:	1265805931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE CHERELL PHILLIPS MSW, LCSW

Provider Business Mailing Address
First Line	:	P.O. BOX 750704
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89136
Country	:	US
Telephone Number	:	702-701-1729
Fax Number	:

Provider Business Practice Location Address
First Line	:	4650 RANCH HOUSE RD UNIT 134
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4605
Country	:	US
Telephone Number	:	702-701-1729
Fax Number	:

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

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	05/07/2025

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