Wild, Kathleen

Wild, Kathleen is an individual health care provider with primary practice located at 6375 W Charleston Blvd Ste A100, Las Vegas NV 89146-1139. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wild, Kathleen can be contacted via phone (702) 253-0818.

Contact Information

Primary practice address
6375 W Charleston Blvd Ste A100 Las Vegas NV 89146-1139
Fax: (702) 253-9625
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 5457 C Nevada

Profile Details

NPI number 1023061801
LBN Legal business name Wild, Kathleen
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated May 14th, 2021 - about 3 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 1023061801 NPPES
Nevada MEDICAID 100507624

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