Provider Demographics
NPI:1659548428
Name:YAO, CONNIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:YAO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9163 W FLAMINGO RD
Mailing Address - Street 2:SUITE #120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6457
Mailing Address - Country:US
Mailing Address - Phone:702-220-5776
Mailing Address - Fax:702-869-9203
Practice Address - Street 1:9163 W FLAMINGO RD
Practice Address - Street 2:SUITE #120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6457
Practice Address - Country:US
Practice Address - Phone:702-220-5776
Practice Address - Fax:702-869-9203
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2643-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical