MEDICARE: DELESPINASSE CONSULTING, INC

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	5357-C	NV

General Provider Information

NPI Number	:	1588091318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELESPINASSE CONSULTING, INC

Provider Business Mailing Address
First Line	:	900 KAREN AVE
Second Line	:	SUITE C-207
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-1264
Country	:	US
Telephone Number	:	702-241-1249
Fax Number	:	702-310-6594

Provider Business Practice Location Address
First Line	:	7728 ROBINDALE CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2063
Country	:	US
Telephone Number	:	702-241-1249
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. EILEEN CAROL DELESPINASSE
Credential	:	LCSW
Telephone Number	:	702-241-1249

Provider Enumeration Date	:	10/13/2013
Last Update Date	:	10/13/2013

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