Provider Demographics
NPI:1194110890
Name:PRICE, JEFFREY L (CADC, LCSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:PRICE
Suffix:
Gender:M
Credentials:CADC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 COURT ST STE 3
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-3505
Mailing Address - Country:US
Mailing Address - Phone:775-375-5061
Mailing Address - Fax:
Practice Address - Street 1:429 COURT ST STE 3
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-3505
Practice Address - Country:US
Practice Address - Phone:775-375-5061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NV1041C0700X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)