Provider Demographics
NPI:1427420728
Name:BARGHOUTI, JINAN ABDELRAHIM (CPC-INTERN, LADC)
Entity type:Individual
Prefix:MISS
First Name:JINAN
Middle Name:ABDELRAHIM
Last Name:BARGHOUTI
Suffix:
Gender:F
Credentials:CPC-INTERN, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 N MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3850
Mailing Address - Country:US
Mailing Address - Phone:775-445-7371
Mailing Address - Fax:
Practice Address - Street 1:1080 N MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3850
Practice Address - Country:US
Practice Address - Phone:775-847-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01872-L101YA0400X
NVCI-770101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)