Provider Demographics
NPI:1326278557
Name:SHORTZ, BARBARA LLOYD
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LLOYD
Last Name:SHORTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:LLOYD
Other - Last Name:SHORTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, MFT, LCADC
Mailing Address - Street 1:1590 AZTEC WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3167
Mailing Address - Country:US
Mailing Address - Phone:702-809-4028
Mailing Address - Fax:702-307-0269
Practice Address - Street 1:1590 AZTEC WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3167
Practice Address - Country:US
Practice Address - Phone:702-809-4028
Practice Address - Fax:702-307-0269
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00108-LC101YA0400X
NV337106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)