Provider Demographics
NPI:1992389530
Name:AADEE H. MIZRACHI, PLLC
Entity Type:Organization
Organization Name:AADEE H. MIZRACHI, PLLC
Other - Org Name:BOULDER BEHAVIORAL HEALTH & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AADEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIZRACHI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-372-6910
Mailing Address - Street 1:9550 S EASTERN AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-8045
Mailing Address - Country:US
Mailing Address - Phone:725-605-4310
Mailing Address - Fax:725-605-4316
Practice Address - Street 1:9550 S EASTERN AVE STE 220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-8045
Practice Address - Country:US
Practice Address - Phone:725-605-4310
Practice Address - Fax:725-605-4316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty