Provider Demographics
NPI:1821457474
Name:SNCC
Entity Type:Organization
Organization Name:SNCC
Other - Org Name:SOUTHERN NEVADA COUNSELING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PSR
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELIZAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-340-8760
Mailing Address - Street 1:8832 QUAIL COUNTRY WAY APT 26-204
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8832 QUAIL COUNTRY WAY APT 26-204
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3478
Practice Address - Country:US
Practice Address - Phone:469-340-8760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health