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NPI Code Detail

MEDICARE: ROBERTO RUIZ VALDEZ LCADC, LCPC

MEDICARE: ROBERTO RUIZ VALDEZ LCADC, LCPC
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
1101YM0800XMental Health CounselorCP029NV

General Provider Information

NPI Number : 1275822652
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERTO RUIZ VALDEZ LCADC, LCPC
Provider Business Mailing Address
First Line : 714 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-2942
Country : US
Telephone Number : 702-292-0397
Fax Number :
Provider Business Practice Location Address
First Line : 714 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-2942
Country : US
Telephone Number : 702-369-8700
Fax Number : 702-369-8489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2011
Last Update Date : 08/26/2021

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