Provider Demographics
NPI:1700096658
Name:SUMMIT FAMILY COUNSELING, LLC
Entity Type:Organization
Organization Name:SUMMIT FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, MFT
Authorized Official - Phone:702-568-5888
Mailing Address - Street 1:220 E HORIZON DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-8035
Mailing Address - Country:US
Mailing Address - Phone:702-568-5888
Mailing Address - Fax:702-568-7554
Practice Address - Street 1:220 E HORIZON DR
Practice Address - Street 2:SUITE G
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-8035
Practice Address - Country:US
Practice Address - Phone:702-568-5888
Practice Address - Fax:702-568-7554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1144L101YA0400X
NVR03320106H00000X
NV01072106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV01072OtherMARRIAGE AND FAMILY THERAPY
NVR03320OtherMARIAGE FAMILY THERAPY-I
NV1144LOtherLICENSED ALCOHOL AND DRUG