Provider Demographics
NPI:1699257402
Name:ASAF, BETH (LPC)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:ASAF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 RENAISSANCE DR STE B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6160
Mailing Address - Country:US
Mailing Address - Phone:702-732-0304
Mailing Address - Fax:702-279-2815
Practice Address - Street 1:2309 RENAISSANCE DR STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6160
Practice Address - Country:US
Practice Address - Phone:702-732-0304
Practice Address - Fax:702-279-2815
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP0296101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional