Provider Demographics
NPI:1730209610
Name:BALTON, MARIANNE (LMSW, ACSW)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:BALTON
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 PECOS RD
Mailing Address - Street 2:VA SOUTHERN NEVADA MENTAL HEALTH BLDG. ROOM 1E128
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-4400
Mailing Address - Country:US
Mailing Address - Phone:702-791-9000
Mailing Address - Fax:702-224-6906
Practice Address - Street 1:6900 PECOS RD
Practice Address - Street 2:VA SOUTHERN NEVADA MENTAL HEALTH BLDG. ROOM 1E128
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9000
Practice Address - Fax:702-224-6906
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010864961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical