Provider Demographics
NPI:1710360714
Name:ATLAS COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:ATLAS COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1775-575-2284
Mailing Address - Street 1:415 US HIGHWAY 95A S
Mailing Address - Street 2:SUITE 702G
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-9261
Mailing Address - Country:US
Mailing Address - Phone:775-575-2284
Mailing Address - Fax:775-575-2384
Practice Address - Street 1:415 US HIGHWAY 95A S
Practice Address - Street 2:SUITE 702G
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9261
Practice Address - Country:US
Practice Address - Phone:775-575-2284
Practice Address - Fax:775-575-2384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20151405713251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health