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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1154706356 | NPPES |
Nevada | MEDICAID | 20144064283 |
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