Provider Demographics
NPI:1447732185
Name:ROUSE, JAMES TERRELL
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:TERRELL
Last Name:ROUSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 N GREEN VALLEY PKWY STE 8C
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5990
Mailing Address - Country:US
Mailing Address - Phone:725-444-3803
Mailing Address - Fax:702-441-0356
Practice Address - Street 1:1701 N GREEN VALLEY PKWY STE 8C
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5990
Practice Address - Country:US
Practice Address - Phone:702-461-4402
Practice Address - Fax:702-441-0356
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLBA0822103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst