Provider Demographics
NPI:1942980602
Name:TEMPEST, AMARA WINTER (CPC INTERN)
Entity Type:Individual
Prefix:
First Name:AMARA
Middle Name:WINTER
Last Name:TEMPEST
Suffix:
Gender:F
Credentials:CPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 S MARYLAND PKWY STE 314
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7520
Mailing Address - Country:US
Mailing Address - Phone:702-625-9735
Mailing Address - Fax:
Practice Address - Street 1:222 S RAINBOW BLVD STE 114
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5343
Practice Address - Country:US
Practice Address - Phone:702-625-0735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5310101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health