Provider Demographics
NPI:1376918029
Name:SILVER STATE COUNSELING AND THERAPY LLC
Entity Type:Organization
Organization Name:SILVER STATE COUNSELING AND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST/OWNE
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:775-230-4423
Mailing Address - Street 1:2125 GREEN VISTA DR STE 106
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-8515
Mailing Address - Country:US
Mailing Address - Phone:775-622-8890
Mailing Address - Fax:775-622-8920
Practice Address - Street 1:2125 GREEN VISTA DR STE 106
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-8515
Practice Address - Country:US
Practice Address - Phone:775-622-8890
Practice Address - Fax:775-622-8920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0468106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1831428697Medicaid