Provider Demographics
NPI:1881299964
Name:FELIPE, MELANIE DELACRUZ
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:DELACRUZ
Last Name:FELIPE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:DELACRUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5390 COMSTOCK LODE LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2031
Mailing Address - Country:US
Mailing Address - Phone:702-280-2989
Mailing Address - Fax:
Practice Address - Street 1:5659 DUNCAN DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2811
Practice Address - Country:US
Practice Address - Phone:725-780-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV02614-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)