Provider Demographics
NPI:1487748950
Name:DYMEK, GARY RICHARD (LCSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:RICHARD
Last Name:DYMEK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4316 E. TROPICANA AVE
Mailing Address - Street 2:#77
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121
Mailing Address - Country:US
Mailing Address - Phone:702-451-2141
Mailing Address - Fax:702-451-5977
Practice Address - Street 1:2725 E DESERT INN RD
Practice Address - Street 2:STE 180
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3627
Practice Address - Country:US
Practice Address - Phone:702-252-8342
Practice Address - Fax:702-252-8349
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2716-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV39554Medicare PIN