Bergquist, Kathleen Leilani
Bergquist, Kathleen Leilani is an individual health care provider with primary practice located at 9739 Manheim Ln , Las Vegas NV 89117-6921. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bergquist, Kathleen Leilani can be contacted via phone (702) 301-3417.Contact Information
Primary practice address
9739 Manheim Ln
Las Vegas NV 89117-6921
Phone: (702) 301-3417
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 5485-C | Nevada |
Profile Details
| NPI number | 1730134578 |
|---|---|
| LBN Legal business name | Bergquist, Kathleen Leilani |
| Credentials | , MSW, LCSW, PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Aug 2nd, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730134578 | NPPES |
| Nevada | MEDICAID | 100508688 |
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