Organization
MARILYN LAMASCUS, LCSW, LLC
Active
Other names
Providence Behavioral Health Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN LAMASCUS LCSW (EXECUTIVE DIRECTOR)
(702) 629-6351
Entity
Organization
Contact information
Practice address
2441 TECH CENTER CT, SUITE108, LAS VEGAS, NV 89128-0804
(702) 629-6351
(702) 629-6367
Mailing address
2441 TECH CENTER CT, SUITE108, LAS VEGAS, NV 89128-0804
(702) 629-6351
(702) 629-6367
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3074-C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11703712
CAQH ID#
NV
01
—
1174700736
GROUP NPI
NV
01
—
412714
MHN
NV
Enumeration date
01/25/2008
Last updated
06/25/2008
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