Individual
ELYSSA MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT-I, CPC-I, CADC-I
Contact information
Practice address
4221 MCLEOD DR, LAS VEGAS, NV 89121-5215
(702) 474-6450
Mailing address
4221 MCLEOD DR, LAS VEGAS, NV 89121-5215
(702) 474-6450
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07180-LCI
NV
101YP2500X
Professional Counselor
Primary
C15112
NV
106H00000X
Marriage & Family Therapist
MI4221
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
CADC-I
NV
Enumeration date
07/06/2016
Last updated
06/13/2023
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