MEDICARE: JESSICA LEE HASS 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	7374-C	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316388127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LEE HASS LCSW

Provider Business Mailing Address
First Line	:	1607 E WINDMILL LN STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1910
Country	:	US
Telephone Number	:	702-757-8720
Fax Number	:	702-974-4677

Provider Business Practice Location Address
First Line	:	1607 E WINDMILL LN STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1910
Country	:	US
Telephone Number	:	27-578-7207
Fax Number	:	702-974-4677

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

Provider Enumeration Date	:	07/09/2013
Last Update Date	:	08/12/2022

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