Provider Demographics
NPI:1033474481
Name:METOYER, ALLIE NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:NICOLE
Last Name:METOYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 FLORAL RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-6352
Mailing Address - Country:US
Mailing Address - Phone:775-313-5353
Mailing Address - Fax:
Practice Address - Street 1:1034 FLORAL RIDGE WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-6352
Practice Address - Country:US
Practice Address - Phone:775-313-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8791-C1041C0700X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical