Provider Demographics
NPI:1982027892
Name:STICKS AND STONES BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:STICKS AND STONES BEHAVIORAL HEALTH
Other - Org Name:TONIA WILLIAMS MCCANDLESS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANDLESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-813-9484
Mailing Address - Street 1:3531 E RUSSELL RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2246
Mailing Address - Country:US
Mailing Address - Phone:702-813-9484
Mailing Address - Fax:
Practice Address - Street 1:3531 E RUSSELL RD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2246
Practice Address - Country:US
Practice Address - Phone:702-813-9484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20101623411251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health