| Theravada Mental Health Llc | |
|
1607 E Windmill Ln Ste 300 Las Vegas NV 89123-1910 | |
| (702) 757-8720 | |
| (702) 974-4677 |
| Full Name | Theravada Mental Health Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1607 E Windmill Ln Ste 300, Las Vegas, Nevada |
| Authorized Official Name and Position | Jessica Hass (OWNER) |
| Authorized Official Contact | 7027578720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theravada Mental Health Llc 1607 E Windmill Ln Ste 300 Las Vegas NV 89123-1910 Ph: (702) 757-8720 | Theravada Mental Health Llc 1607 E Windmill Ln Ste 300 Las Vegas NV 89123-1910 Ph: (702) 757-8720 |
| NPI Number | 1114414109 |
|---|---|
| Provider Enumeration Date | 04/16/2018 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 6608122882 |
|---|---|
| Medicare Enrollment ID | O20181206000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114414109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | NV20171279356 (Nevada) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sally K Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801985296 PECOS PAC ID: 2163472655 Enrollment ID: I20050122000068 |
| Provider Name | Jordan Hendricks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801136247 PECOS PAC ID: 2567766645 Enrollment ID: I20160210001372 |
| Provider Name | Edward Fenn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023274768 PECOS PAC ID: 7517254188 Enrollment ID: I20160926000644 |
| Provider Name | Erin L Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568907012 PECOS PAC ID: 5092099929 Enrollment ID: I20170221001612 |
| Provider Name | Jessica L Hass |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316388127 PECOS PAC ID: 3678839479 Enrollment ID: I20171110002089 |
| Provider Name | Michele Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760930580 PECOS PAC ID: 8729314331 Enrollment ID: I20190719000413 |
| Provider Name | Sarah C Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366719221 PECOS PAC ID: 3779916846 Enrollment ID: I20191203001827 |
| Provider Name | Sara Hernandez-moya |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881066512 PECOS PAC ID: 4587086426 Enrollment ID: I20200622002262 |
| Provider Name | Chrystal B Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841593969 PECOS PAC ID: 5294150348 Enrollment ID: I20200806000555 |
| Provider Name | Jessica L Burton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184107906 PECOS PAC ID: 5496175903 Enrollment ID: I20201022002543 |
| Provider Name | Krystin H Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558836551 PECOS PAC ID: 3274940374 Enrollment ID: I20210407000745 |
| Provider Name | Natalia G Samoylova |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609207869 PECOS PAC ID: 5597154732 Enrollment ID: I20211110000538 |
| Provider Name | Melanie Roberts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164786828 PECOS PAC ID: 0042655821 Enrollment ID: I20240302000577 |
| Provider Name | Alicia Rocha |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1568084952 PECOS PAC ID: 8022453802 Enrollment ID: I20240302000645 |
| Provider Name | Megan Mengistu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386216406 PECOS PAC ID: 0840635629 Enrollment ID: I20240302000652 |
| Provider Name | Joe Dentice |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306258157 PECOS PAC ID: 1759726532 Enrollment ID: I20240302000655 |
| Provider Name | Anna L Hodges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477835387 PECOS PAC ID: 0042652216 Enrollment ID: I20240521000534 |
| Provider Name | Crystal Acosta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972115889 PECOS PAC ID: 3577905744 Enrollment ID: I20240521000632 |
| Provider Name | Phonemany Thongkham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376898486 PECOS PAC ID: 5991147175 Enrollment ID: I20240521001225 |
| Provider Name | Bethany Kammert |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669996898 PECOS PAC ID: 9537501622 Enrollment ID: I20240521001511 |
| Provider Name | Lauren Blank |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1891440442 PECOS PAC ID: 7719411107 Enrollment ID: I20241107001573 |
| Provider Name | Colette Meighan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598246167 PECOS PAC ID: 6901321322 Enrollment ID: I20250418000236 |
| Provider Name | Rochelle Dechowitz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639799281 PECOS PAC ID: 6406371830 Enrollment ID: I20250418000387 |
| Provider Name | Brandi Jointer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467033928 PECOS PAC ID: 9436674702 Enrollment ID: I20250418001439 |
| Provider Name | Atrell Patton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750986055 PECOS PAC ID: 6002331386 Enrollment ID: I20250418001752 |
| Provider Name | Dana Seidlinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790567899 PECOS PAC ID: 5991220279 Enrollment ID: I20250418001818 |
| Provider Name | Victoria Shvets |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336762988 PECOS PAC ID: 1355887324 Enrollment ID: I20250418001896 |
| Provider Name | Sara Tribble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760008122 PECOS PAC ID: 2668997958 Enrollment ID: I20250418002035 |
| Provider Name | Darlington Ugbodu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306298229 PECOS PAC ID: 4385169671 Enrollment ID: I20250418002106 |
| Provider Name | Darlene Zepp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134825441 PECOS PAC ID: 5193240489 Enrollment ID: I20250418002149 |
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