Provider Demographics
NPI:1942646229
Name:GONZALEZ-BUENO, ARIANNA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ARIANNA
Middle Name:
Last Name:GONZALEZ-BUENO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 RESEARCH WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-7913
Mailing Address - Country:US
Mailing Address - Phone:775-888-6610
Mailing Address - Fax:
Practice Address - Street 1:2212 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-4124
Practice Address - Country:US
Practice Address - Phone:702-735-9334
Practice Address - Fax:702-735-9335
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
NV8239-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8239-COtherLCSW LICENSE - NEVADA
NV1942646229Medicaid