Daxea Deweese, LSW, CDAC-I

Primary specialty

Social WorkerTaxonomy code 104100000X

License

7635-S Issued in NV

Practice address

2105 Capurro Way Ste 105
Sparks, NV 89431-8586

Phone

(775) 455-4260

NPI assigned

Feb 27, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Youth Eastside Services

  • Community/Behavioral Health Agency
  • Bellevue, WA
  • NPI 1356496335
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1861993602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 CAPURRO WAY STE 105",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 CAPURRO WAY STE 105",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894318586",
            "telephone_number": "775-455-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "DAXEA",
        "credential": "LSW, CDAC-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "02292-I",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "7635-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colton Destrempes
• Kristal Deville
• Kyle Devine, MSW
• Lisa Ann Devonick, PHARMD
• Douglas K Devries, O.D.
• Inderpreet Kaur Dhanjal
• Dollie Dhillon, RBT
• Diane M Thomas M D P C
• Diane M. Schaub Birth Cottage
• Sucelly Melissa Diaz Erazo

• Social Worker in Sparks, NV
• Providers in Sparks, NV by specialty
• Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.