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NPI Code Detail

MEDICARE: NOURISHED MINDS LLC

MEDICARE: NOURISHED MINDS 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1669270674
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOURISHED MINDS LLC
Provider Business Mailing Address
First Line : 2300 W SAHARA AVE STE 800
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4397
Country : US
Telephone Number : 702-713-8207
Fax Number :
Provider Business Practice Location Address
First Line : 2300 W SAHARA AVE STE 800
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4397
Country : US
Telephone Number : 702-713-8207
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. WAYNNESHA WEDLOW
Credential : LCSW
Telephone Number : 702-713-8207
Provider Enumeration Date : 03/05/2025
Last Update Date : 03/02/2026

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Directions to “NOURISHED MINDS LLC ” Practice Location

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