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NPI Code Detail

MEDICARE: CHRISTINE LEANN ACKMANN L.C.S.W.

MEDICARE:   CHRISTINE LEANN ACKMANN  L.C.S.W.
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 Worker3560163501UT
21041C0700XClinical Social Worker5553-CNV

General Provider Information

NPI Number : 1689789448
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE LEANN ACKMANN L.C.S.W.
Provider Business Mailing Address
First Line : FLORENCE MCCLURE CORRECTIONAL CENTER
Second Line : 4370 SMILEY RD
City : LAS VEGAS
State : NV
Zip : 89115
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : FLORENCE MCCLURE CORRECTIONAL CENTER
Second Line : 4370 SMILEY RD
City : LAS VEGAS
State : NV
Zip : 89115
Country : US
Telephone Number : 702-668-7200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 11/17/2016

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Directions to “ CHRISTINE LEANN ACKMANN L.C.S.W.” Practice Location

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