Provider Demographics
NPI:1780104158
Name:SENDAK, SHELLEY KARA (PHD)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:KARA
Last Name:SENDAK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1696 RAVANUSA DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3103
Mailing Address - Country:US
Mailing Address - Phone:702-997-2070
Mailing Address - Fax:
Practice Address - Street 1:2298 W HORIZON RIDGE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2698
Practice Address - Country:US
Practice Address - Phone:702-363-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVM10692106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist