Provider Demographics
NPI:1194129262
Name:SINISI, MEGAN J (CADC, NCAC I, SAP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:J
Last Name:SINISI
Suffix:
Gender:F
Credentials:CADC, NCAC I, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 ISADORA CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2350
Mailing Address - Country:US
Mailing Address - Phone:702-907-6344
Mailing Address - Fax:
Practice Address - Street 1:7371 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1575
Practice Address - Country:US
Practice Address - Phone:702-907-6344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0371-C101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)