Organization
VON DIAGNOSTIC AND COUNSELING,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS MONTAVON LCSW, LADC (THERAPIST)
(702) 917-0367
Entity
Organization
Contact information
Practice address
4560 S EASTERN AVE, SUITE 13, LAS VEGAS, NV 89119-6182
(702) 613-7060
Mailing address
5172 JEWEL CANYON DR, LAS VEGAS, NV 89122-8328
(702) 917-0367
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LADC 01322-L
NV
1041C0700X
Clinical Social Worker
Primary
LCSW 7031-C
NV
Other
Enumeration date
09/06/2015
Last updated
09/06/2015
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