MEDICARE: MS. JACQUELINE GLASPER-SATTWHITE BS,MBA,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	101Y00000X	Counselor
2	1041C0700X	Clinical Social Worker	9028-C	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1285910075	OTHER	NV	PRIVATE PRACTICE

General Provider Information

NPI Number	:	1285910075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JACQUELINE GLASPER-SATTWHITE BS,MBA,LCSW

Provider Business Mailing Address
First Line	:	3925 N MARTIN L KING BLVD STE 212
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7676
Country	:	US
Telephone Number	:	702-444-0235
Fax Number	:	702-992-3505

Provider Business Practice Location Address
First Line	:	3925 N MARTIN L KING BLVD STE 212
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7676
Country	:	US
Telephone Number	:	702-444-0235
Fax Number	:	702-992-3505

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

Provider Enumeration Date	:	10/25/2011
Last Update Date	:	10/19/2021

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