| 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 | Stephanie A Maxfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134331234 PECOS PAC ID: 2163685207 Enrollment ID: I20140804000196 |
| 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 | Sarah C Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366719221 PECOS PAC ID: 3779916846 Enrollment ID: I20191203001827 |
| Provider Name | Stacey C Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992228233 PECOS PAC ID: 7315374816 Enrollment ID: I20200222000035 |
| 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 | 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 | Charlene Paule |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437707486 PECOS PAC ID: 6305216599 Enrollment ID: I20230104001894 |
| 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 |
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