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

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XMI3202 (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.