Provider Demographics
NPI:1568808582
Name:INFANTE, KATIE DIANE (MS, LMFT, LADC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:DIANE
Last Name:INFANTE
Suffix:
Gender:F
Credentials:MS, LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7495 W AZURE DR STE 252
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4417
Mailing Address - Country:US
Mailing Address - Phone:702-920-0757
Mailing Address - Fax:
Practice Address - Street 1:7495 W AZURE DR STE 252
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4417
Practice Address - Country:US
Practice Address - Phone:702-920-0757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01556-L101YA0400X
NV01263106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)