Provider Demographics
NPI:1215470778
Name:KAYANO, LILIAN (LCSW)
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:
Last Name:KAYANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9615 W FLAMINGO RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-5735
Mailing Address - Country:US
Mailing Address - Phone:702-748-7046
Mailing Address - Fax:
Practice Address - Street 1:6048 S DURANGO DR STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1781
Practice Address - Country:US
Practice Address - Phone:702-815-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2024-01-29
Deactivation Date:2017-12-31
Deactivation Code:
Reactivation Date:2021-09-09
Provider Licenses
StateLicense IDTaxonomies
NV11226-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical