# LIVING WATERS TRAUMA INSTITUTE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780010876
- **Authorized official:** MRS. CHRISTINA LOUISE SANFORD LCSW (FOUNDING CEO)
- **Authorized official phone:** (702) 577-4118

## Contact information

- **Practice address:** 6130 ELTON AVE, SUITE 201, LAS VEGAS, NV 89107-2538
- **Practice address phone:** (702) 577-4118
- **Practice address fax:** (702) 216-6001
- **Mailing address:** 5828 MARIA DEL MAR ST, LAS VEGAS, NV 89130-7299
- **Mailing address phone:** (702) 577-4118
- **Mailing address fax:** (702) 216-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 5312-C | NV | Yes |

## Other

- **Enumeration date:** 09/20/2013
- **Last updated:** 09/20/2013