Provider Demographics
NPI:1730832510
Name:DE BECKER, KAI (LMFT-I, MS)
Entity type:Individual
Prefix:MS
First Name:KAI
Middle Name:
Last Name:DE BECKER
Suffix:
Gender:F
Credentials:LMFT-I, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 W FLAMINGO RD STE 110-148
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6410
Mailing Address - Country:US
Mailing Address - Phone:702-885-1819
Mailing Address - Fax:
Practice Address - Street 1:6730 S FORT APACHE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-885-1819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI3146106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty