Provider Demographics
NPI:1588954382
Name:QUALLS, BARBARA L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:L
Last Name:QUALLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 BREEZE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5131
Mailing Address - Country:US
Mailing Address - Phone:702-606-4662
Mailing Address - Fax:
Practice Address - Street 1:233 BREEZE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5131
Practice Address - Country:US
Practice Address - Phone:702-606-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical