Provider Demographics
NPI:1528406592
Name:RICE, ROBERT (LCSW INTERN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:LCSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 W POST RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2435
Mailing Address - Country:US
Mailing Address - Phone:702-405-2213
Mailing Address - Fax:702-788-9411
Practice Address - Street 1:1701 W CHARLESTON BLVD
Practice Address - Street 2:STE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2325
Practice Address - Country:US
Practice Address - Phone:702-405-2213
Practice Address - Fax:702-788-9411
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01098101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)