Provider Demographics
NPI:1669768396
Name:COQUELET-MEYER, MADELAINE HEIDI (MFT, LCADC)
Entity type:Individual
Prefix:
First Name:MADELAINE
Middle Name:HEIDI
Last Name:COQUELET-MEYER
Suffix:
Gender:F
Credentials:MFT, LCADC
Other - Prefix:
Other - First Name:MADELAINE
Other - Middle Name:
Other - Last Name:COQUELET-MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT, LCADC
Mailing Address - Street 1:9317 LOTUS ELAN DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7103
Mailing Address - Country:US
Mailing Address - Phone:702-418-6401
Mailing Address - Fax:702-849-9540
Practice Address - Street 1:8430 W LAKE MEAD BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7674
Practice Address - Country:US
Practice Address - Phone:702-849-9540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV518-LC101YA0400X
NV2571106H00000X
NV01736-L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist