Individual provider Active NPI

Magdalena Guevara-Fayad, PSY.D, LMFT, LCADC

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1003193574
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
01134 Issued in NV
Practice address
2720 N Tenaya Way FL 2
Las Vegas, NV 89128-0424
Phone
(702) 797-2322
Fax
(702) 579-1038
NPI assigned
Nov 10, 2011
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00296-P NV
Marriage & Family Therapist 106H00000X 01134 NV Primary

Addresses

Primary practice location

2720 N Tenaya Way FL 2
Las Vegas, NV 89128-0424

Mailing address

4301 Terrapin Mountain Ave
Las Vegas, NV 89129-4523
Phone (702) 251-8000

Other practice location 1

501 S Rancho Dr Ste C17
Las Vegas, NV 89106-4831
Phone (702) 301-1636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00296-PNVMDAddiction (Substance Use Disorder) Counselor
01134NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PHC of Nevada Inc Addiction (Substance Use Disorder) PastSince Aug 1, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1003193574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 TERRAPIN MOUNTAIN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891294523",
            "telephone_number": "702-251-8000",
            "fax_number": "702-380-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N TENAYA WAY FL 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280424",
            "telephone_number": "702-797-2322",
            "fax_number": "702-579-1038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Rancho Dr Ste C17",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064831",
            "country_code": "US",
            "telephone_number": "702-301-1636",
            "fax_number": "702-366-0352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA-FAYAD",
        "first_name": "MAGDALENA",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LMFT, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "00296-P",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.