MEDICARE: SHELBY H NAKAMURA LMFT

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	106H00000X	Marriage & Family Therapist	4126	NV

General Provider Information

NPI Number	:	1306488077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY H NAKAMURA LMFT

Provider Business Mailing Address
First Line	:	7361 W CHARLESTON BLVD STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1576
Country	:	US
Telephone Number	:	702-623-5571
Fax Number	:	702-685-0549

Provider Business Practice Location Address
First Line	:	7361 W CHARLESTON BLVD STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1576
Country	:	US
Telephone Number	:	702-623-5571
Fax Number	:	702-685-0549

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

Provider Enumeration Date	:	10/14/2019
Last Update Date	:	12/13/2024

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