Provider Demographics
NPI:1548706526
Name:DONALD POSSON, PH.D., LADC
Entity type:Organization
Organization Name:DONALD POSSON, PH.D., LADC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:POSSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LADC
Authorized Official - Phone:702-684-1455
Mailing Address - Street 1:6867 W CHARLESTON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1669
Mailing Address - Country:US
Mailing Address - Phone:702-684-1455
Mailing Address - Fax:
Practice Address - Street 1:6867 W CHARLESTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1669
Practice Address - Country:US
Practice Address - Phone:702-684-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health