Provider Demographics
NPI:1952763211
Name:SHIELD-RICE, TAMMY (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:SHIELD-RICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:SHIELD RICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1000 N GREEN VALLEY PKWY # 440-167
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6170
Mailing Address - Country:US
Mailing Address - Phone:702-704-5615
Mailing Address - Fax:
Practice Address - Street 1:2470 SAINT ROSE PKWY STE 213
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7776
Practice Address - Country:US
Practice Address - Phone:702-475-9751
Practice Address - Fax:702-830-7350
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6900-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical