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NPI Code Detail

MEDICARE: SHALEE CARTER LMSW

MEDICARE: SHALEE CARTER LMSW
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
1104100000XSocial Worker1628P-MNV

General Provider Information

NPI Number : 1891465720
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALEE CARTER LMSW
Provider Business Mailing Address
First Line : 5311 SPARKLING VINE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-5287
Country : US
Telephone Number : 801-710-2076
Fax Number :
Provider Business Practice Location Address
First Line : 3890 W ANN RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4416
Country : US
Telephone Number : 702-287-8895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2021
Last Update Date : 09/13/2021

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