# MENTAL EDGE THERAPY PROFESSIONAL LLC

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

## Provider details

- **NPI number:** 1831799915
- **Authorized official:** MRS. NICOLE MCDONAGH CPC-I, LADC, C.HT. (OWNER)
- **Authorized official phone:** (702) 483-1990

## Contact information

- **Practice address:** 2520 SAINT ROSE PKWY STE 220A, HENDERSON, NV 89074-7789
- **Practice address phone:** (702) 483-1990
- **Mailing address:** 2520 SAINT ROSE PKWY STE 220A, HENDERSON, NV 89074-7789
- **Mailing address phone:** (702) 483-1990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |

## Other

- **Enumeration date:** 10/28/2020
- **Last updated:** 10/28/2020