Provider Demographics
NPI:1699364422
Name:WINTERS, MARLA ELLEN (LPCC)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:ELLEN
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8134 MADDINGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7638
Mailing Address - Country:US
Mailing Address - Phone:702-600-2013
Mailing Address - Fax:
Practice Address - Street 1:8134 MADDINGLEY AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7638
Practice Address - Country:US
Practice Address - Phone:702-600-2013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional