Provider Demographics
NPI:1811462435
Name:KRISCHKE, DENISE FAYE (LMSW, CSW-I)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:FAYE
Last Name:KRISCHKE
Suffix:
Gender:F
Credentials:LMSW, CSW-I
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:FAYE
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 230355
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89105-0355
Mailing Address - Country:US
Mailing Address - Phone:805-236-9925
Mailing Address - Fax:702-922-6600
Practice Address - Street 1:2881 S VALLEY VIEW BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0171
Practice Address - Country:US
Practice Address - Phone:702-922-7015
Practice Address - Fax:702-922-6600
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NV9540-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program