MEDICARE: LINDIA DARLIAN KEY

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	104100000X	Social Worker	5804-S	NV
3	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1992000384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDIA DARLIAN KEY

Provider Business Mailing Address
First Line	:	5905 W CHARLESTON BLVD
Second Line	:	APT 210
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1194
Country	:	US
Telephone Number	:	702-456-9269
Fax Number	:

Provider Business Practice Location Address
First Line	:	2445 FIRE MESA ST
Second Line	:	#190
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9014
Country	:	US
Telephone Number	:	702-212-3008
Fax Number	:	702-933-3064

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

Provider Enumeration Date	:	01/17/2011
Last Update Date	:	01/17/2011

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Directions to “ LINDIA DARLIAN KEY ” Practice Location

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