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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730134578 NPPES
Nevada MEDICAID 100508688

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