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COMMUNITY YOUTH INTERALIA NPI 1790282002


NPI Information

NPI: 1790282002
Provider Name: COMMUNITY YOUTH INTERALIA

Doing Business As: SEAO INTERALIA

Classification: Psychologist - 103TE1100X
Entity Type: Organization

Specialization: Exercise & Sports

Address:
9082 VINTAGE WINE AVE
LAS VEGAS, NV
ZIP 89148
Phone: (702) 328-0459
Get Directions

COMMUNITY YOUTH INTERALIA is an exercise and sports psychologist in Las Vegas, NV. The provider is a psychologist with a proficiency in sports psychology that uses psychological knowledge and skills to address optimal performance and well-being of athletes, developmental and social aspects of sports participation, and systemic issues associated with sports settings and organizations. APA recognizes sport psychology as a proficiency acquired after a doctoral degree in one of the primary areas of psychology and licensure as a psychologist. This proficiency does not include those who have earned a doctoral degree in sport psychology but are not licensed psychologists. COMMUNITY YOUTH INTERALIA NPI is 1790282002. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Seao Interalia.

The provider's business location address is:

9082 VINTAGE WINE AVE
LAS VEGAS, NV
ZIP 89148-916
Phone: (702) 328-0459

The provider's authorized official is Jude Niba .
The authorized official title is President and has the following contact phone number (702) 328-0459.

The enumeration date for this NPI number is 4/12/2018 and was last updated on 4/12/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TE1100XPsychologistExercise & Sports667NEVADAYes

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

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