Provider Demographics
NPI:1134260235
Name:SALKOFF, LUCY
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:
Last Name:SALKOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LUCILLE
Other - Middle Name:
Other - Last Name:SALKOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:HC 33 BOX 3005
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89124-9251
Mailing Address - Country:US
Mailing Address - Phone:702-217-8974
Mailing Address - Fax:
Practice Address - Street 1:4538 W CRAIG RD
Practice Address - Street 2:SUITE 290
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2508
Practice Address - Country:US
Practice Address - Phone:702-486-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC23891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical