Provider Demographics
NPI:1083328835
Name:SALTER, STEPHEN MARK (LICENSED MFT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MARK
Last Name:SALTER
Suffix:
Gender:M
Credentials:LICENSED MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 S GREEN VALLEY PKWY UNIT 5312
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2316
Mailing Address - Country:US
Mailing Address - Phone:619-246-8682
Mailing Address - Fax:
Practice Address - Street 1:251 S GREEN VALLEY PKWY UNIT 5312
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-2316
Practice Address - Country:US
Practice Address - Phone:619-246-8682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51699106H00000X
NV4135-R106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist