MEDICARE: TRIDENT BEHAVIORAL HEALTH LLC

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1649990029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIDENT BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	9308 CANALINO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0538
Country	:	US
Telephone Number	:	702-533-7344
Fax Number	:

Provider Business Practice Location Address
First Line	:	9315 W SUNSET RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5012
Country	:	US
Telephone Number	:	702-638-7705
Fax Number	:	702-638-7706

Authorized Official
Title or Position	:	PROVIDER
Name	:	BELINDA ORDEN
Credential	:	APRN
Telephone Number	:	702-533-7344

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	02/19/2023

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