Provider Demographics
NPI:1518253558
Name:MAIKWE PARSONS MSW JD LLC
Entity Type:Organization
Organization Name:MAIKWE PARSONS MSW JD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAIKWE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-321-7567
Mailing Address - Street 1:6698 STARSHELL BAY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6113
Mailing Address - Country:US
Mailing Address - Phone:702-321-7567
Mailing Address - Fax:702-534-4037
Practice Address - Street 1:5145 S. DURANGO DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0191
Practice Address - Country:US
Practice Address - Phone:702-321-7567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0414-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty