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NPI Code Detail

MEDICARE: MRS. SADARIE SMITH

MEDICARE: MRS. SADARIE SMITH
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) Counselor02260-INV
2101YM0800XMental Health Counselor
3104100000XSocial Worker7559-SNV

General Provider Information

NPI Number : 1902284151
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SADARIE SMITH
Provider Business Mailing Address
First Line : 5175 JERRY TARKANIAN WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5163
Country : US
Telephone Number : 702-540-1202
Fax Number :
Provider Business Practice Location Address
First Line : 2801 S VALLEY VIEW BLVD STE 6
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-0166
Country : US
Telephone Number : 702-922-7015
Fax Number : 702-922-6600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2015
Last Update Date : 03/17/2018

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Directions to “ MRS. SADARIE SMITH ” Practice Location

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