Provider Demographics
NPI:1346733094
Name:ACOSTA, DONNA (LMFT, RDN, ACE-CHC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:LMFT, RDN, ACE-CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 EPSON ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7247
Mailing Address - Country:US
Mailing Address - Phone:702-238-4748
Mailing Address - Fax:
Practice Address - Street 1:6769 W CHARLESTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9005
Practice Address - Country:US
Practice Address - Phone:702-238-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist