| Lbr Mental Health Pllc | |
|
2620 Regatta Dr Ste 102 Las Vegas NV 89128-6892 | |
| (702) 208-9080 | |
| Not Available |
| Full Name | Lbr Mental Health Pllc |
|---|---|
| Speciality | Specialist |
| Location | 2620 Regatta Dr Ste 102, Las Vegas, Nevada |
| Authorized Official Name and Position | Lileana Roque (DIRECTOR/OWNER) |
| Authorized Official Contact | 7022089080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lbr Mental Health Pllc 2620 Regatta Dr Ste 102 Las Vegas NV 89128-6892 Ph: (702) 208-9080 | Lbr Mental Health Pllc 2620 Regatta Dr Ste 102 Las Vegas NV 89128-6892 Ph: (702) 208-9080 |
| NPI Number | 1922862226 |
|---|---|
| Provider Enumeration Date | 02/08/2024 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Medicare PECOS PAC ID | 4284167032 |
|---|---|
| Medicare Enrollment ID | O20241031002159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922862226 | NPI | - | NPPES |
| Provider Name | Phonemany Thongkham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376898486 PECOS PAC ID: 5991147175 Enrollment ID: I20240521001225 |
| Provider Name | Lileana Roque |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174933626 PECOS PAC ID: 7810420882 Enrollment ID: I20241029003079 |
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