|
| |
|
3035 S. Maryland Parkway Suite 110 Las Vegas NV 89109 | |
| (702) 978-8100 | |
| (702) 857-8801 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3035 S. Maryland Parkway, Las Vegas, Nevada |
| Authorized Official Name and Position | Abby Grossa (CFO) |
| Authorized Official Contact | 7023388373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2921 N. Tenaya Way Las Vegas NV 89128-0454 Ph: (702) 683-2591 | 3035 S. Maryland Parkway Suite 110 Las Vegas NV 89109 Ph: (702) 978-8100 |
| NPI Number | 1699158600 |
|---|---|
| Provider Enumeration Date | 07/08/2015 |
| Last Update Date | 03/13/2019 |
| Medicare PECOS PAC ID | 0345657979 |
|---|---|
| Medicare Enrollment ID | O20210329000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699158600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ward K Swallow |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871626564 PECOS PAC ID: 6507842630 Enrollment ID: I20040628001542 |
| Provider Name | Skarlet D Forwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710242375 PECOS PAC ID: 5395044564 Enrollment ID: I20160422001320 |
| Provider Name | Virgilio Desio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073764239 PECOS PAC ID: 3274815493 Enrollment ID: I20170124002038 |
| Provider Name | Brenna Elaine Benas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841636008 PECOS PAC ID: 4082042734 Enrollment ID: I20200312000942 |
| Provider Name | William Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679797633 PECOS PAC ID: 6002906096 Enrollment ID: I20200622000938 |
| Provider Name | Rachel Coffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053428524 PECOS PAC ID: 5799192308 Enrollment ID: I20210326002307 |
| Provider Name | Rory Reid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679023196 PECOS PAC ID: 9638587413 Enrollment ID: I20210415000905 |
| Provider Name | Anna Slowek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588263768 PECOS PAC ID: 0446668016 Enrollment ID: I20210420001409 |
| Provider Name | David J Ventrelle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639342140 PECOS PAC ID: 1850437369 Enrollment ID: I20220815000650 |
| Provider Name | Liam Alexander Paige |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083969885 PECOS PAC ID: 1052795846 Enrollment ID: I20220828000082 |
| Provider Name | Channel Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386055267 PECOS PAC ID: 6800259193 Enrollment ID: I20230905001839 |
| Provider Name | Melissa Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669048781 PECOS PAC ID: 8628422862 Enrollment ID: I20230921003744 |
| Provider Name | Justin Lee Arnold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144622408 PECOS PAC ID: 3375998610 Enrollment ID: I20231006001161 |
| Provider Name | Khoury Kelsey Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265959746 PECOS PAC ID: 1951751213 Enrollment ID: I20231228002162 |
| Provider Name | Louis G. Sisto |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1578873527 PECOS PAC ID: 6800246992 Enrollment ID: I20240102003383 |
| Provider Name | Andre Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699012898 PECOS PAC ID: 6204289218 Enrollment ID: I20240125004045 |
| Provider Name | Jacqueline Fry |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1801334701 PECOS PAC ID: 2567815335 Enrollment ID: I20240129000735 |
| Provider Name | Artelia A Coleman |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1629237623 PECOS PAC ID: 5799120242 Enrollment ID: I20240223003919 |
| Provider Name | Casey Rene Casillas-nichols |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710323720 PECOS PAC ID: 5193160489 Enrollment ID: I20240226004034 |
| Provider Name | Janet Aispuro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396358966 PECOS PAC ID: 1658718663 Enrollment ID: I20240326004275 |
| Provider Name | Linda Aboagye-kwakye |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699175505 PECOS PAC ID: 7214378173 Enrollment ID: I20240509003773 |
| Provider Name | Matthew David Jordan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568672418 PECOS PAC ID: 7315484060 Enrollment ID: I20240731001149 |
| Provider Name | Zdenka Prus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427206598 PECOS PAC ID: 6507392032 Enrollment ID: I20241208000115 |
Creating Empowerment Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4773 Madrid Ridge Ct, Las Vegas, NV 89129 Phone: 702-656-9890 Fax: 702-656-9152 | |
No Obstacles Mental Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8565 S Eastern Ave, Suite 174, Las Vegas, NV 89123 Phone: 702-462-3082 | |
The Village Behavior Health Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6330 Mcleod Dr, Suite 4&5, Las Vegas, NV 89120 Phone: 702-437-0341 | |
Journey Community Health Organization Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6512 N Decatur Blvd, Suite 130-114, Las Vegas, NV 89131 Phone: 702-830-2481 Fax: 702-664-0648 |