Provider Demographics
NPI:1427756873
Name:SAKOWSKI, NICHOLAS RUSSELL EDWARD I (LMSW, CSW-I)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:RUSSELL EDWARD
Last Name:SAKOWSKI
Suffix:I
Gender:M
Credentials:LMSW, CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 REFLECTION WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-4443
Mailing Address - Country:US
Mailing Address - Phone:702-741-1417
Mailing Address - Fax:
Practice Address - Street 1:2121 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2205
Practice Address - Country:US
Practice Address - Phone:702-382-7746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical