Provider Demographics
NPI:1336480730
Name:NUNEZ, MARIVELLE (LMFT, LCADC)
Entity Type:Individual
Prefix:
First Name:MARIVELLE
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:LMFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 SKOKIE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1382
Mailing Address - Country:US
Mailing Address - Phone:702-374-8500
Mailing Address - Fax:
Practice Address - Street 1:7495 W AZURE DR STE 246
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4436
Practice Address - Country:US
Practice Address - Phone:702-302-4288
Practice Address - Fax:702-790-2570
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-09
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00445-P101YA0400X
NVMI0202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV$$$$$$$$$Medicaid