Provider Demographics
NPI:1376140376
Name:OVITT, KEVIN ERNEST (LSWP)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:ERNEST
Last Name:OVITT
Suffix:
Gender:M
Credentials:LSWP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 GOLDEN WEST RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-5755
Mailing Address - Country:US
Mailing Address - Phone:775-219-3030
Mailing Address - Fax:
Practice Address - Street 1:315 RECORD ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3327
Practice Address - Country:US
Practice Address - Phone:775-405-4111
Practice Address - Fax:775-405-4410
Is Sole Proprietor?:No
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1262P-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker