Wild, Kathleen
Wild, Kathleen is an individual health care provider with primary practice located at 6375 W Charleston Blvd Ste A100, Las Vegas NV 89146-1139. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wild, Kathleen can be contacted via phone (702) 253-0818.Contact Information
Primary practice address
6375 W Charleston Blvd Ste A100
Las Vegas NV 89146-1139
Phone: (702) 253-0818
Fax: (702) 253-9625
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 5457 C | Nevada |
Profile Details
| NPI number | 1023061801 |
|---|---|
| LBN Legal business name | Wild, Kathleen |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2006 |
| Last updated | May 14th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023061801 | NPPES |
| Nevada | MEDICAID | 100507624 |
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