MEDICARE: MR. KAJ GERARD DOUGLAS SR.

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1316283278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KAJ GERARD DOUGLAS SR.

Provider Business Mailing Address
First Line	:	9550 S EASTERN AVE STE 253
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8042
Country	:	US
Telephone Number	:	702-759-6282
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 S EASTERN AVE
Second Line	:	SUITE 253
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8038
Country	:	US
Telephone Number	:	702-204-9720
Fax Number	:

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

Provider Enumeration Date	:	12/21/2012
Last Update Date	:	07/21/2022

Similar Medicare Providers

1679780225 — NANCY DOMIANO-SADER LCSW
Practice Location Address:

9550 S EASTERN AVE , SUITE 220 - B
LAS VEGAS, NV
89123-8038

Practice Phone: 702-292-8711
Practice Fax:

1134352461 — NATALIE TUCKER BARNES MS, OTR/L
Practice Location Address:

9550 S EASTERN AVE
LAS VEGAS, NV
89123-8038

Practice Phone: 702-444-0774
Practice Fax:

1588969737 — MYMS CORPORATION
Practice Location Address:

9550 S EASTERN AVE , SUITE 253
LAS VEGAS, NV
89123-8038

Practice Phone: 702-860-8573
Practice Fax: 702-562-8133

1710252275 — DOMIANO-SADER THERAPY LLC.
Practice Location Address:

9550 S EASTERN AVE , SUITE 220
LAS VEGAS, NV
89123-8038

Practice Phone: 702-292-8711
Practice Fax: 702-451-9157

1558782904 — MR. MARK SKOMAL
Practice Location Address:

9550 S EASTERN AVE , SUITE 253
LAS VEGAS, NV
89123-8038

Practice Phone: 702-906-7925
Practice Fax:

1316335631 — CHERYL A BOYER LCSW
Practice Location Address:

9550 S EASTERN AVE , 220
LAS VEGAS, NV
89123-8038

Practice Phone: 702-708-2216
Practice Fax:

Directions to “ MR. KAJ GERARD DOUGLAS SR. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.