Provider Demographics
NPI:1982808960
Name:SEVERIN-RUIZ, MILAGROS (LMFT, LCADC, LCADC-S)
Entity type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:
Last Name:SEVERIN-RUIZ
Suffix:
Gender:F
Credentials:LMFT, LCADC, LCADC-S
Other - Prefix:
Other - First Name:MILAGROS
Other - Middle Name:
Other - Last Name:SEVERIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8430 W LAKE MEAD BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7674
Mailing Address - Country:US
Mailing Address - Phone:702-573-5825
Mailing Address - Fax:
Practice Address - Street 1:8430 W LAKE MEAD BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7674
Practice Address - Country:US
Practice Address - Phone:702-573-5825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00554-LC101YA0400X
NV2632106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)