Provider Demographics
NPI:1871072058
Name:RENDINA, KATHRYN (MLSW, LSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:RENDINA
Suffix:
Gender:F
Credentials:MLSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 N BUFFALO DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129
Mailing Address - Country:US
Mailing Address - Phone:702-515-1373
Mailing Address - Fax:702-331-3098
Practice Address - Street 1:3321 N BUFFALO DR
Practice Address - Street 2:SUITE 125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129
Practice Address - Country:US
Practice Address - Phone:702-515-1373
Practice Address - Fax:702-331-3098
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-1171101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health