Provider Demographics
NPI:1487668380
Name:HUNTER, JOLEEN R (LSW)
Entity Type:Individual
Prefix:
First Name:JOLEEN
Middle Name:R
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JOLEEN
Other - Middle Name:R
Other - Last Name:SHREVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 E CHARLESTON BLVD
Mailing Address - Street 2:STE. 230
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-6659
Mailing Address - Country:US
Mailing Address - Phone:702-968-5052
Mailing Address - Fax:702-968-5050
Practice Address - Street 1:4000 E CHARLESTON BLVD
Practice Address - Street 2:STE. 230
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-6659
Practice Address - Country:US
Practice Address - Phone:702-968-5052
Practice Address - Fax:702-968-5050
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4642-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker