Provider Demographics
NPI:1720099450
Name:YOKOBORI, NANCY CROWELL (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:CROWELL
Last Name:YOKOBORI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7455 W WASHINGTON AVE
Mailing Address - Street 2:#480
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4337
Mailing Address - Country:US
Mailing Address - Phone:702-650-0633
Mailing Address - Fax:702-650-0642
Practice Address - Street 1:7455 W WASHINGTON AVE
Practice Address - Street 2:#480
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4337
Practice Address - Country:US
Practice Address - Phone:702-650-0633
Practice Address - Fax:702-650-0642
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4195-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPENDINGMedicaid
NVPENDINGMedicare ID - Type Unspecified