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A Clean Slate Counseling Llc

NPI Registration Record

Provider / OrganizationNPIDate Certified
A CLEAN SLATE COUNSELING LLC10731179332020-11-22

The organization A Clean Slate Counseling Llc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1073117933. Registration indicates A Clean Slate Counseling Llc is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Professional, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Professional, Behavioral Health & Social Service Providers) (Counselor, )

Entity TypeOrganization
Provider OrganizationA CLEAN SLATE COUNSELING LLC
Practice Office Address6390 W CHEYENNE AVE STE F1
LAS VEGAS, NV US
Practice Office Telephone7024692061
Mailing AddressPO BOX 752913
LAS VEGAS, NV 891362913 US
Business Telephone8444644434
Authorized OfficialKISA DAVIS, CREDENTIALING S
8444644434
HPT Codes
CodePractice
License No
State
101YP2500X PRIMARYAccess to Mental Health/Behavioral Health Providers
Behavioral Health & Social Service Providers
Counselor
Behavioral Health & Social Service Providers
Counselor
Counselor: Professional

Behavioral Health/Substance Abuse/Psychiatry

Counselor Professional
Behavioral Health & Social Service Providers
Counselor
193400000X SINGGroup Code
OPI Codes
01685-L OTHER NV LICENSE
Governmental Registrations [CAGE/NCAGE/DUNS]

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