Brushbreaker, Ebony C

Brushbreaker, Ebony C is an sole proprietor health care provider with primary practice located at 7390 W Sahara Ave Ste 240 , Las Vegas NV 89117-2764. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Brushbreaker, Ebony C can be contacted via phone (702) 427-4537.

Contact Information

Primary practice address
7390 W Sahara Ave Ste 240 Las Vegas NV 89117-2764
Phone: (702) 427-4537
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 10879-C Nevada
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-21790 Arizona

Profile Details

NPI number 1154706356
LBN Legal business name Brushbreaker, Ebony C
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2015
Last updated Mar 6th, 2024 - about last year

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 1154706356 NPPES
Nevada MEDICAID 20144064283

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