Organization
ABRAXAS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY CASINO LCSW (CO-FOUNDER)
(702) 412-8405
Entity
Organization
Contact information
Practice address
4575 W COUGAR AVE STE 300, LAS VEGAS, NV 89139-7617
(702) 412-8405
Mailing address
4262 BLUE DIAMOND RD # 102-105, LAS VEGAS, NV 89139-7789
(702) 412-8405
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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