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Organization
MENTAL EDGE THERAPY PROFESSIONAL LLC
Active
Organization
MENTAL EDGE THERAPY PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE MCDONAGH CPC-I, LADC, C.HT. (OWNER)
(702) 483-1990
Entity
Organization
Contact information
Practice address
2520 SAINT ROSE PKWY STE 220A, HENDERSON, NV 89074-7789
(702) 483-1990
Mailing address
2520 SAINT ROSE PKWY STE 220A, HENDERSON, NV 89074-7789
(702) 483-1990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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