Provider Demographics
NPI:1003193574
Name:GUEVARA-FAYAD, MAGDALENA (PSYD, LMFT, LCADC)
Entity Type:Individual
Prefix:DR
First Name:MAGDALENA
Middle Name:
Last Name:GUEVARA-FAYAD
Suffix:
Gender:F
Credentials:PSYD, LMFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 TERRAPIN MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-4523
Mailing Address - Country:US
Mailing Address - Phone:702-251-8000
Mailing Address - Fax:702-380-6925
Practice Address - Street 1:2720 N TENAYA WAY FL 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0424
Practice Address - Country:US
Practice Address - Phone:702-797-2322
Practice Address - Fax:702-579-1038
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00296-P101YA0400X
NV01134106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)