Individual ProviderHolly C ShankCounselorBehavioral Health & Social Service ProvidersPractice Address801 S Rancho Dr # 2, Las Vegas, NV 89106-3854(702) 385-2153PECOS EnrollmentBased on the most recent information from CMS, provider Holly C Shank does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1477957298Provider TypeIndividualFull NameShank, Holly CCredentialLCPC, LADCGenderFemaleSole ProprietorNoEnumeration Date10/22/2014Last Updated6/27/2023Contact InformationPractice LocationPractice Address801 S Rancho Dr # 2, Las Vegas, NV 89106-3854Phone(702) 385-2153FaxUnlisted FaxMailing LocationMailing Address801 S Rancho Dr Ste C3, Las Vegas, NV 89106-3858Phone(702) 385-2153FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseCP5043NevadaCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense01768-LNevada