Jeffrey Allen

Individual provider Active NPI Marriage & Family Therapist · Sparks, NV

NPI 1124339213 · NPPES record last updated Mar 27, 2025

Key facts

NPI
1124339213
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
0764 (NV)
Practice address
PO Box 51831
Sparks, NV 89435-1831
Phone
(775) 848-9392
NPI assigned
Jun 23, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0764NVMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Based Counseling of Nevada Marriage & Family Therapist Current
since Mar 30, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0764 NV Yes

Addresses

Primary practice location

PO Box 51831
Sparks, NV 89435-1831

Mailing address

2748 Kimberlite Rd
Sparks, NV 89436-4110
Phone (775) 848-9392

Other identifiers

IdentifierTypeStateIssuer
1124339213MedicaidNV

Other providers in Sparks, NV

All providers in Sparks, NV · Marriage & Family Therapist in Nevada

Sources for this page

Verify at the official NPI Registry.