Provider Demographics
NPI:1326482514
Name:CLEARWATERS FAMILY GUIDANCE AND WELLNESS CENTERS,LLC
Entity Type:Organization
Organization Name:CLEARWATERS FAMILY GUIDANCE AND WELLNESS CENTERS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-778-5300
Mailing Address - Street 1:3606 N RANCHO DR STE 142
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3130
Mailing Address - Country:US
Mailing Address - Phone:702-778-5300
Mailing Address - Fax:702-778-5301
Practice Address - Street 1:3606 N RANCHO DR
Practice Address - Street 2:SUITE 142
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3195
Practice Address - Country:US
Practice Address - Phone:702-778-5300
Practice Address - Fax:702-778-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health