Provider Demographics
NPI:1427315712
Name:KAISER, DEANNA RACHELLE (LADC, NCC, CPC)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:RACHELLE
Last Name:KAISER
Suffix:
Gender:F
Credentials:LADC, NCC, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E LAKE MEAD PKWY APT 1722
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6418
Mailing Address - Country:US
Mailing Address - Phone:732-887-1920
Mailing Address - Fax:
Practice Address - Street 1:501 E LAKE MEAD PKWY APT 1722
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-6418
Practice Address - Country:US
Practice Address - Phone:732-887-1920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01851-L101YA0400X
NVCI1761101YP2500X
103K00000X
NVCP5274101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst