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Havi Brysk Mandell

Social Worker

Behavioral Health & Social Service Providers

4794 S Eastern Ave, Suite C, Las Vegas, NV 89119-6145

PECOS Enrollment

This provider is enrolled in PECOS as HAVI MANDELL.

Based on the most recent information from CMS, provider Havi Brysk Mandell is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1255529897
Provider Type
Individual
Full Name
Mandell, Havi Brysk
Title
Dr.
Credential
PH.D., MSW, LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/9/2007
Last Updated
2/5/2008

Contact Information

Practice Location

4794 S Eastern Ave, Suite C, Las Vegas, NV 89119-6145

(702) 732-0304

(702) 794-2033

Mailing Location

4794 S Eastern Ave, Suite C, Las Vegas, NV 89119-6145

(702) 732-0304

(702) 794-2033

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 5276-C Nevada

Provider Identifiers

ID	Description	Issuer
ID 1881724250	Description Other	Issuer JFSA Nevada

Havi Brysk Mandell

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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