Basic Information
| Provider Information | |||||||||
| NPI: | 1295331130 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'CONNOR | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10320 WALWORTH AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891666500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024909532 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2881 S VALLEY VIEW BLVD STE 1 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891020145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029227015 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2020 | ||||||||
| LastUpdateDate: | 05/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 9034-S | NV | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.