Provider Demographics
NPI:1891325874
Name:SILVER STATE PSYCHOLOGY
Entity Type:Organization
Organization Name:SILVER STATE PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HRONEK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:702-268-8542
Mailing Address - Street 1:7341 W CHARLESTON BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1578
Mailing Address - Country:US
Mailing Address - Phone:702-268-8542
Mailing Address - Fax:702-268-8719
Practice Address - Street 1:7341 W CHARLESTON BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1578
Practice Address - Country:US
Practice Address - Phone:702-268-8542
Practice Address - Fax:702-268-8719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-18
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty