Provider Demographics
NPI:1952075483
Name:LUSZCZEWSKI, MICHELLE (LMSW, LADC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:LUSZCZEWSKI
Suffix:
Gender:F
Credentials:LMSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 SABLE CREEK ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-1619
Mailing Address - Country:US
Mailing Address - Phone:708-275-3286
Mailing Address - Fax:
Practice Address - Street 1:3321 N BUFFALO DR STE 125
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6678
Practice Address - Country:US
Practice Address - Phone:702-880-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-07
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06855-L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)