Provider Demographics
NPI:1780192278
Name:LABANTE COUNSELING & EDUCATION SERVICES L.L.C.
Entity Type:Organization
Organization Name:LABANTE COUNSELING & EDUCATION SERVICES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AYELE
Authorized Official - Middle Name:ELAVAGNON
Authorized Official - Last Name:AMAVIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, MSW, LSW
Authorized Official - Phone:702-806-9143
Mailing Address - Street 1:6121 MEADOW VIEW LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-1121
Mailing Address - Country:US
Mailing Address - Phone:702-806-9143
Mailing Address - Fax:866-280-9477
Practice Address - Street 1:2585 S JONES BLVD STE 2F
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5604
Practice Address - Country:US
Practice Address - Phone:702-806-9143
Practice Address - Fax:866-280-9477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5116-S251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health