Active NPI
Mariya Tkachenko
- Mental Health Counselor
- Carson City, NV
National Provider Identifier
1013790807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CI5318
- Practice address
- 755 N Roop St Ste 101
Carson City, NV 89701-3107 - Phone
- (775) 841-6050
- NPI assigned
- Aug 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CI5318 | NV | Primary |
Addresses
Primary practice location
755 N Roop St Ste 101
Carson City, NV 89701-3107
Mailing address
1821 Lake Tahoe Blvd
Apt. Aa7
South Lake Tahoe, CA 96150
Phone (925) 448-0713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CI5318 | NV | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1013790807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1821 LAKE TAHOE BLVD",
"address_2": "APT. AA7",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "96150",
"telephone_number": "925-448-0713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 N ROOP ST STE 101",
"city": "CARSON CITY",
"state": "NV",
"postal_code": "897013107",
"telephone_number": "775-841-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TKACHENKO",
"first_name": "MARIYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-15",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CI5318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carson City, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.