Individual ProviderKatie ThibeauxCounselorBehavioral Health & Social Service ProvidersPractice Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146(702) 437-4673PECOS EnrollmentBased on the most recent information from CMS, provider Katie Thibeaux 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 2 days ago.Profile DetailsProvider ID1538716642Provider TypeIndividualFull NameThibeaux, KatieGenderFemaleSole ProprietorYesEnumeration Date8/22/2019Last Updated8/22/2019Contact InformationPractice LocationPractice Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146Phone(702) 437-4673FaxUnlisted FaxMailing LocationMailing Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067Phone(702) 437-4673FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer