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NPI Code Detail

MEDICARE: P&P MENTAL HEALTH SERVICES INC

MEDICARE: P&P MENTAL HEALTH SERVICES 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
1101YP1600XPastoral Counselor
2106H00000XMarriage & Family Therapist
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1639945454
Entity Type Code : Organization
Provider Name (Legal Business Name) : P&P MENTAL HEALTH SERVICES INC
Provider Business Mailing Address
First Line : 2112 INTERBAY ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-6502
Country : US
Telephone Number : 702-219-5283
Fax Number :
Provider Business Practice Location Address
First Line : 6034 SMOKE RANCH RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-3700
Country : US
Telephone Number : 702-352-3193
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. PRINCE CHRISTIAN IGBOAMAZU
Credential : LCPC-I
Telephone Number : 702-219-5283
Provider Enumeration Date : 12/01/2023
Last Update Date : 12/01/2023

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Directions to “P&P MENTAL HEALTH SERVICES INC ” Practice Location

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