Provider Demographics
NPI:1699598029
Name:KACHNIK, ALISON T (LMSW, CSW INTERN)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:T
Last Name:KACHNIK
Suffix:
Gender:F
Credentials:LMSW, CSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 E DESERT ROSE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-8014
Mailing Address - Country:US
Mailing Address - Phone:770-363-0697
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?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5755-M104100000X
NVIC-25511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker