Basic Information
| Provider Information | |||||||||
| NPI: | 1487748950 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DYMEK | ||||||||
| FirstName: | GARY | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4316 E. TROPICANA AVE | ||||||||
| Address2: | #77 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024512141 | ||||||||
| FaxNumber: | 7024515977 | ||||||||
| Practice Location | |||||||||
| Address1: | 2725 E DESERT INN RD | ||||||||
| Address2: | STE 180 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891213627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022528342 | ||||||||
| FaxNumber: | 7022528349 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 04/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 2716-C | NV | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.