Provider Demographics
NPI:1710252275
Name:DOMIANO-SADER THERAPY LLC.
Entity Type:Organization
Organization Name:DOMIANO-SADER THERAPY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMIANO-SADER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LADC
Authorized Official - Phone:702-945-1600
Mailing Address - Street 1:9550 S EASTERN AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-8038
Mailing Address - Country:US
Mailing Address - Phone:702-945-1600
Mailing Address - Fax:702-451-9157
Practice Address - Street 1:9550 S EASTERN AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-8038
Practice Address - Country:US
Practice Address - Phone:702-292-8711
Practice Address - Fax:702-451-9157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV11890842OtherCAQH