Individual provider Active NPI

Nia Fowler-Galloway, LMFT

  • Marriage & Family Therapist
  • Henderson, NV
National Provider Identifier
1023609070
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4649 Issued in NV
Practice address
2538 Anthem Village Dr Ste 135
Henderson, NV 89052-5561
Phone
(702) 659-9043
Fax
(801) 877-0864
NPI assigned
Feb 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4649 NV Primary

Addresses

Primary practice location

2538 Anthem Village Dr Ste 135
Henderson, NV 89052-5561

Mailing address

PO Box 50207
Provo, UT 84605-0207
Phone (702) 659-9043

Other practice location 1

2298 W Horizon Ridge Pkwy Ste 201
Henderson, NV 89052-2698
Phone (702) 605-0974

Other practice location 2

4626 N 300 W Ste 150
Provo, UT 84604-6077
Phone (801) 407-4134

Other practice location 3

9494 W Flamingo Rd Ste 101
Las Vegas, NV 89147-5718
Phone (702) 659-9043

Other practice location 4

393 E Riverside Dr Ste 3A
St George, UT 84790-7127
Phone (435) 688-2123

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

LicenseStateTypeSpecialty
4649NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sela Health, PLLC Marriage & Family Therapist PastSince Nov 5, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1023609070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50207",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846050207",
            "telephone_number": "702-659-9043",
            "fax_number": "801-877-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2538 ANTHEM VILLAGE DR STE 135",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525561",
            "telephone_number": "702-659-9043",
            "fax_number": "801-877-0864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2298 W Horizon Ridge Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890522698",
            "country_code": "US",
            "telephone_number": "702-605-0974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4626 N 300 W Ste 150",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846046077",
            "country_code": "US",
            "telephone_number": "801-407-4134",
            "fax_number": "801-877-0864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9494 W Flamingo Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891475718",
            "country_code": "US",
            "telephone_number": "702-659-9043",
            "fax_number": "801-877-0864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "393 E Riverside Dr Ste 3A",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847907127",
            "country_code": "US",
            "telephone_number": "435-688-2123",
            "fax_number": "801-877-0864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER-GALLOWAY",
        "first_name": "NIA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "4649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.

Verify at the official NPI Registry.