Provider Demographics
NPI:1265661946
Name:NEUBAUER, NICHOLAS L (MSW)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:L
Last Name:NEUBAUER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2313 SUNRISE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6926
Mailing Address - Country:US
Mailing Address - Phone:702-806-5268
Mailing Address - Fax:702-222-3275
Practice Address - Street 1:6402 MCLEOD DR
Practice Address - Street 2:SUITE #5
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4405
Practice Address - Country:US
Practice Address - Phone:702-898-5311
Practice Address - Fax:702-222-3275
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical