MEDICARE: LION MIND THERAPY

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

General Provider Information

NPI Number	:	1528994563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LION MIND THERAPY

Provider Business Mailing Address
First Line	:	6166 S SANDHILL RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3215
Country	:	US
Telephone Number	:	302-889-0119
Fax Number	:

Provider Business Practice Location Address
First Line	:	6166 S SANDHILL RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3215
Country	:	US
Telephone Number	:	302-889-0119
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RON PERETZ
Credential	:	LCSW
Telephone Number	:	702-835-2626

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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Directions to “LION MIND THERAPY ” Practice Location

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