Provider Demographics
NPI:1568262400
Name:SHRIMPLIN, CHARLA JEAN (LMSW)
Entity type:Individual
Prefix:MS
First Name:CHARLA
Middle Name:JEAN
Last Name:SHRIMPLIN
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 411
Mailing Address - Street 2:
Mailing Address - City:CIMA
Mailing Address - State:CA
Mailing Address - Zip Code:92323-9701
Mailing Address - Country:US
Mailing Address - Phone:702-381-1974
Mailing Address - Fax:
Practice Address - Street 1:8685 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2839
Practice Address - Country:US
Practice Address - Phone:702-754-0807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6138-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker