NPI 1831863315 · live from the CMS NPI Registry
1111 Therapy & Mental Health Institute
Counselor, Mental Health in Las Vegas, NV. National Provider Identifier 1831863315, active.
NPI record
| NPI | 1831863315 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 1504 Blackcombe St Unit 204, Las Vegas, NV 89128 |
| Practice phone | 404-849-9918 |
| Enumerated | August 6, 2021 |
| Last updated | August 6, 2021 |
| Authorized official | Rodney Bumpers, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Drama Therapist | 101200000X | — |
| Art Therapist | 221700000X | — |
| Rehabilitation Practitioner | 225400000X | — |
| Dance Therapist | 225600000X | — |
| Music Therapist | 225A00000X | — |
| Counselor | 101Y00000X | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Psychiatry & Neurology, Psychosomatic Medicine | 2084P0015X | — |
| Rehabilitation Counselor | 225C00000X | — |
| Case Management | 251B00000X | — |
| Community/Behavioral Health | 251S00000X | — |
| Assisted Living Facility, Assisted Living, Behavioral Disturbances | 3104A0630X | — |
| Community Based Residential Treatment Facility, Mental Illness | 320800000X | — |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 320900000X | — |
| Counselor, Mental Health primary | 101YM0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.