Provider Demographics
NPI:1982171989
Name:ALEX, GLENDOLYN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:GLENDOLYN
Middle Name:
Last Name:ALEX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:GLEN
Other - Middle Name:
Other - Last Name:ALEX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7575 W WASHINGTON AVE STE 127-462
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4333
Mailing Address - Country:US
Mailing Address - Phone:702-807-7349
Mailing Address - Fax:702-804-6369
Practice Address - Street 1:8751 W CHARLESTON BLVD STE 150-14
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5480
Practice Address - Country:US
Practice Address - Phone:702-807-7349
Practice Address - Fax:702-804-6369
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC29731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical