ROOSEVELT DAYMON NPI 1356949846

NPI Information

NPI: 1356949846
Provider Name: ROOSEVELT DAYMON
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
2725 S JONES BLVD STE 101
LAS VEGAS, NV
ZIP 89146
Phone: (702) 588-3425
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Roosevelt Daymon is a counselor in Las Vegas, NV. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Roosevelt Daymon NPI is 1356949846. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2725 S JONES BLVD STE 101
LAS VEGAS, NV
ZIP 89146-605
Phone: (702) 588-3425

The enumeration date for this NPI number is 10/15/2020 and was last updated on 10/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor				Yes
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NV20071459752	OTHER		2D CHANCE INC.
2	NV20071459752	MEDICAID	NEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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