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NPI Code Detail

MEDICARE: MELISA CELIS CADC-I

MEDICARE: MELISA CELIS CADC-I
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
1106S00000XBehavior Technician
2101YA0400XAddiction (Substance Use Disorder) Counselor08021-INV

General Provider Information

NPI Number : 1972166759
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISA CELIS CADC-I
Provider Business Mailing Address
First Line : 6402 MCLEOD DR STE 5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4406
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6402 MCLEOD DR STE 5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4406
Country : US
Telephone Number : 725-204-8809
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2019
Last Update Date : 06/03/2025

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Directions to “ MELISA CELIS CADC-I” Practice Location

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