Provider Demographics
NPI:1639656960
Name:PAYUMO, FELIPE DE LEON (LSW, CSW INTERN)
Entity Type:Individual
Prefix:MR
First Name:FELIPE
Middle Name:DE LEON
Last Name:PAYUMO
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Gender:M
Credentials:LSW, CSW INTERN
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Mailing Address - Street 1:3321 N BUFFALO DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129
Mailing Address - Country:US
Mailing Address - Phone:702-515-1373
Mailing Address - Fax:702-331-3098
Practice Address - Street 1:3321 N BUFFALO DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129
Practice Address - Country:US
Practice Address - Phone:702-515-1373
Practice Address - Fax:702-331-3098
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV7598-5101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health