Provider Demographics
NPI:1043088925
Name:SACKEY, ENOCH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ENOCH
Middle Name:
Last Name:SACKEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 E SUNSET RD # 5-823
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3511
Mailing Address - Country:US
Mailing Address - Phone:702-685-0877
Mailing Address - Fax:702-749-5922
Practice Address - Street 1:2320 PASEO DEL PRADO STE B208
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4332
Practice Address - Country:US
Practice Address - Phone:702-685-0877
Practice Address - Fax:702-749-5922
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY61421638103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical