Provider Demographics
NPI:1588945158
Name:CHURCHWRIGHT INC
Entity type:Organization
Organization Name:CHURCHWRIGHT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-530-1141
Mailing Address - Street 1:8275 S EASTERN AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2591
Mailing Address - Country:US
Mailing Address - Phone:702-530-1141
Mailing Address - Fax:702-938-1023
Practice Address - Street 1:8275 S EASTERN AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2591
Practice Address - Country:US
Practice Address - Phone:702-530-1141
Practice Address - Fax:702-938-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0528103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVFM420AOtherMEDICARE PTAN