Provider Demographics
NPI:1912207994
Name:NEW FOCUS COUNSELING CENTER OF NEVADA, LLC
Entity Type:Organization
Organization Name:NEW FOCUS COUNSELING CENTER OF NEVADA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:EVENS
Authorized Official - Last Name:BOMER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:702-639-7524
Mailing Address - Street 1:7351 W. CHARLESTON BLVD STE. 140
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117
Mailing Address - Country:US
Mailing Address - Phone:702-639-7524
Mailing Address - Fax:702-476-3141
Practice Address - Street 1:7351 W. CHARLESTON BLVD STE. 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117
Practice Address - Country:US
Practice Address - Phone:702-639-7524
Practice Address - Fax:702-476-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5642-C1041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty