MEDICARE: ILIA T SANCHEZ 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	225400000X	Rehabilitation Practitioner
2	1041C0700X	Clinical Social Worker	7114-C	NV

General Provider Information

NPI Number	:	1326358763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILIA T SANCHEZ LCSW

Provider Business Mailing Address
First Line	:	4001 S DECATUR BLVD STE 25
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5857
Country	:	US
Telephone Number	:	725-224-6967
Fax Number	:	833-749-0357

Provider Business Practice Location Address
First Line	:	4001 S DECATUR BLVD STE 25
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-5857
Country	:	US
Telephone Number	:	725-224-6967
Fax Number	:	833-749-0357

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

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	09/22/2022

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Directions to “ ILIA T SANCHEZ LCSW” Practice Location

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