MEDICARE: KAREN MICHELLE ERVIN

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	9855-C	NV
2	172V00000X	Community Health Worker
3	104100000X	Social Worker	8394-S	NV

General Provider Information

NPI Number	:	1619462538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN MICHELLE ERVIN

Provider Business Mailing Address
First Line	:	10501 W GOWAN RD STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10501 W GOWAN RD STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6602
Country	:	US
Telephone Number	:	702-482-8063
Fax Number	:

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

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	11/04/2025

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Directions to “ KAREN MICHELLE ERVIN ” Practice Location

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