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Jollene Stiles-Bradsher

Social Worker

Behavioral Health & Social Service Providers

1771 E Flamingo Rd Ste 106a, Las Vegas, NV 89119-5156

PECOS Enrollment

Based on the most recent information from CMS, provider Jollene Stiles-Bradsher 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
1780953844
Provider Type
Individual
Full Name
Stiles-Bradsher, Jollene
Title
Ms.
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/19/2011
Last Updated
1/14/2021

Contact Information

Practice Location

1771 E Flamingo Rd Ste 106a, Las Vegas, NV 89119-5156

(702) 318-7544

Unlisted Fax

Mailing Location

1771 E Flamingo Rd Ste 106a, Las Vegas, NV 89119-5156

(702) 318-7544

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 5731-C Nevada
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License LCS 25304 California

Jollene Stiles-Bradsher

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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