Organization
NUEVA VIDA MENTAL HEALTH LLC
Active
Other names
NVMH
Organization subpart
No
Provider details
NPI number
Authorized official
MARYSOL REZANOV (MENTAL HEALTH THERAPIST)
(702) 659-8827
Entity
Organization
Contact information
Practice address
4170 S DECATUR BLVD STE C1, LAS VEGAS, NV 89103-5863
(702) 659-8827
(702) 852-0984
Mailing address
4170 S DECATUR BLVD STE C1, LAS VEGAS, NV 89103-5863
(702) 659-8827
(702) 852-0984
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6215-C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003116146
—
NV
01
—
1003127499
INDIVIDUAL NPI
NV
05
—
1225338361
—
NV
05
—
1316606874
—
NV
05
—
1407281561
—
NV
05
—
1497120059
—
NV
05
—
1891867107
—
NV
05
—
1982056172
—
NV
Enumeration date
09/10/2012
Last updated
02/27/2025
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