Provider Demographics
NPI:1316262009
Name:MOUYIOS, JEFFREY (LCSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MOUYIOS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 ROBINSON LN
Mailing Address - Street 2:
Mailing Address - City:BOULDER CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89005-1131
Mailing Address - Country:US
Mailing Address - Phone:406-218-9977
Mailing Address - Fax:
Practice Address - Street 1:2520 SAINT ROSE PKWY STE 202B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:406-218-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9231041C0700X
NV5772-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical