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NPI Code Detail

MEDICARE: JACQUELINE ESTRADA MA, MFT, LADC

MEDICARE: JACQUELINE ESTRADA MA, MFT, LADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor00485-LCNV
2106H00000XMarriage & Family TherapistMFC 44416CA
3106H00000XMarriage & Family Therapist01351NV

General Provider Information

NPI Number : 1700170370
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE ESTRADA MA, MFT, LADC
Provider Business Mailing Address
First Line : 4221 MCLEOD DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5215
Country : US
Telephone Number : 702-474-6450
Fax Number :
Provider Business Practice Location Address
First Line : 4221 MCLEOD DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5215
Country : US
Telephone Number : 702-474-6450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2011
Last Update Date : 04/10/2025

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