Organization
BROKENSHELLS CONSULTING LLC
Active
Other names
Brokenshells Consulting LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JAZMINE SMITH MFT-I (OWNER)
(404) 428-0019
Entity
Organization
Contact information
Practice address
800 N RAINBOW BLVD STE 208, LAS VEGAS, NV 89107-1193
(404) 428-0019
Mailing address
3621 BROXBURN ST, LAS VEGAS, NV 89108-5340
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-2143136
—
NV
Enumeration date
07/12/2021
Last updated
07/12/2021
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