MEDICARE: MS. DAWN L STARKS-BALL LCSW

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
1	1041C0700X	Clinical Social Worker	6730-C	NV

General Provider Information

NPI Number	:	1962693465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DAWN L STARKS-BALL LCSW

Provider Business Mailing Address
First Line	:	5135 CAMINO AL NORTE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2387
Country	:	US
Telephone Number	:	718-312-2379
Fax Number	:

Provider Business Practice Location Address
First Line	:	5135 CAMINO AL NORTE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2387
Country	:	US
Telephone Number	:	702-550-8750
Fax Number	:	702-974-8629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	03/21/2024

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