Provider Demographics
NPI:1295387470
Name:CORDER, BRITTANY ELISE (LSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ELISE
Last Name:CORDER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 W SAHARA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0319
Mailing Address - Country:US
Mailing Address - Phone:702-248-6290
Mailing Address - Fax:702-248-4720
Practice Address - Street 1:5300 W SAHARA AVE STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0319
Practice Address - Country:US
Practice Address - Phone:702-248-6290
Practice Address - Fax:702-248-4720
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8426-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker