Provider Demographics
NPI:1336727106
Name:GOMEZ-HETHERMAN, ASHLY (LCSW)
Entity type:Individual
Prefix:
First Name:ASHLY
Middle Name:
Last Name:GOMEZ-HETHERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASHLY
Other - Middle Name:S
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1917 TOSCANINI WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0650
Mailing Address - Country:US
Mailing Address - Phone:702-339-2928
Mailing Address - Fax:
Practice Address - Street 1:3016 W CHARLESTON BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1964
Practice Address - Country:US
Practice Address - Phone:702-412-9077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12206-C225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor