Provider Demographics
NPI:1710427356
Name:SANNIA FARINA, MARIA MERCEDES (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MERCEDES
Last Name:SANNIA FARINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MERCEDES
Other - Last Name:PERONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2255 RENAISSANCE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6194
Mailing Address - Country:US
Mailing Address - Phone:702-471-0420
Mailing Address - Fax:702-450-4239
Practice Address - Street 1:2255 RENAISSANCE DR STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6194
Practice Address - Country:US
Practice Address - Phone:702-471-0420
Practice Address - Fax:702-450-4239
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7366S1041C0700X
NV8339-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical