MEDICARE: NAMI WESTERN NEVADA

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	172V00000X	Community Health Worker
2	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1366332744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAMI WESTERN NEVADA

Provider Business Mailing Address
First Line	:	3094 RESEARCH WAY STE 61
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89706-7964
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3094 RESEARCH WAY STE 61
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89706-7964
Country	:	US
Telephone Number	:	775-350-7977
Fax Number	:

Authorized Official
Title or Position	:	DEPUTY DIRECTOR
Name	:	NICOLE MARA
Credential	:
Telephone Number	:	775-350-7977

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	12/03/2025

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Directions to “NAMI WESTERN NEVADA ” Practice Location

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