Provider Demographics
NPI:1346776416
Name:SOUTHERN NEVADA COUNSELING LLC
Entity Type:Organization
Organization Name:SOUTHERN NEVADA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-727-4000
Mailing Address - Street 1:1440 E CALVADA BLVD STE 900
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5856
Mailing Address - Country:US
Mailing Address - Phone:775-727-4000
Mailing Address - Fax:775-727-3789
Practice Address - Street 1:1440 E CALVADA BLVD STE 900
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5856
Practice Address - Country:US
Practice Address - Phone:775-727-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-10
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20171293435101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty