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Jade Kay-Marie Larson-Houck

Social Worker

Behavioral Health & Social Service Providers

4045 Spencer St Ste A48, Las Vegas, NV 89119-5245

PECOS Enrollment

This provider is enrolled in PECOS as JADE LARSON-HOUCK.

Based on the most recent information from CMS, provider Jade Kay-Marie Larson-Houck 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
1366961971
Provider Type
Individual
Full Name
Larson-Houck, Jade Kay-Marie
Gender
Female

Sole Proprietor
No
Enumeration Date
9/14/2017
Last Updated
10/5/2022

Contact Information

Practice Location

4045 Spencer St Ste A48, Las Vegas, NV 89119-5245

(702) 483-0190

Unlisted Fax

Mailing Location

4045 Spencer St Ste A48, Las Vegas, NV 89119-5245

(702) 483-0190

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 10297-C Nevada
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License 1630 Nevada

Jade Kay-Marie Larson-Houck

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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Johnson, Scott J

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