Provider Demographics
NPI:1508345786
Name:MACPHERSON, J'AIME NICOLE
Entity Type:Individual
Prefix:
First Name:J'AIME
Middle Name:NICOLE
Last Name:MACPHERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10873 WALLFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-2862
Mailing Address - Country:US
Mailing Address - Phone:702-672-3128
Mailing Address - Fax:
Practice Address - Street 1:9148 W LAKE MEAD BLVD
Practice Address - Street 2:STE. 316
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134
Practice Address - Country:US
Practice Address - Phone:702-438-7800
Practice Address - Fax:702-445-6454
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0924106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist