Individual provider · Type 1 NPI
Jackson Cryses Nightshade
Mental Health Counselor · Las Vegas, NV
NPI number
1255689261
Active · reactivated Aug 4, 2023
Practice location
2300 W Sahara Ave Ste 800
Las Vegas, NV 89102-4397
Mailing address
1027 S Rainbow Blvd Pmb 186
Las Vegas, NV 89145-6232
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | MI3202 (NV) |
Mental Health Counselor: Definition to come...
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About NPI 1255689261
Jackson Cryses Nightshade's National Provider Identifier is 1255689261, issued on Aug 22, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Las Vegas, NV. The record was last updated on Aug 4, 2023.