Basic Information
| Provider Information | |||||||||
| NPI: | 1699870758 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERTONE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW, LADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 736 MONICO DR | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894038108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752410480 | ||||||||
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| Practice Location | |||||||||
| Address1: | 65 CONTINENTAL DR | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895093432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753343033 | ||||||||
| FaxNumber: | 7753343022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 101YA0400X | 397-L | NV | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | 2821-C | NV | X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.