Provider Demographics
NPI:1912325408
Name:WEBB, JENNIFER (CPC-I)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 E SUNSET RD
Mailing Address - Street 2:#24
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120
Mailing Address - Country:US
Mailing Address - Phone:702-270-3219
Mailing Address - Fax:866-833-2056
Practice Address - Street 1:2881 S VALLEY VIEW BLVD STE 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0145
Practice Address - Country:US
Practice Address - Phone:702-922-7015
Practice Address - Fax:702-922-6600
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCABI00086103K00000X
NVCI5192101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCABI00086OtherCABI