Provider Demographics
NPI:1730489154
Name:CLEARWATERS FAMILY GUIDANCE AND WELLNESS CENTERS LLC
Entity type:Organization
Organization Name:CLEARWATERS FAMILY GUIDANCE AND WELLNESS CENTERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:702-278-0984
Mailing Address - Street 1:3606 N RANCHO DR STE 142
Mailing Address - Street 2:LAS VEGAS
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3130
Mailing Address - Country:US
Mailing Address - Phone:702-778-5300
Mailing Address - Fax:702-778-5301
Practice Address - Street 1:3606 N RANCHO DR
Practice Address - Street 2:STE 142
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3195
Practice Address - Country:US
Practice Address - Phone:702-778-5300
Practice Address - Fax:702-778-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVC20101008-0249251S00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty