Brokenshells Wellness Center LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

BROKENSHELLS WELLNESS CENTER LLC

Doing business as

Brokenshells Wellness Center

Practice address

3895 Quadrel St
Las Vegas, NV 89129-5507

Phone

(404) 428-0019

NPI assigned

Oct 16, 2024

Organization subpart

No

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

Authorized official

Name

Jazmine Smith, MFTNPI 1134420862

Title

Owner

Phone

(404) 428-0019

Specialties & licenses 1

Addresses

Other names 1

• Brokenshells Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jazmine Smith

  • Marriage & Family Therapist
  • Las Vegas, NV
  • NPI 1134420862
  Medicare reassignment NPD Authorized official
• Lashekia Smith-Brown, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1063879708
  NPD

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1043030893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3895 QUADREL ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891295507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 QUADREL ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891295507",
            "telephone_number": "404-428-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKENSHELLS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JAZMINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-428-0019",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brokenshells Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gina Laura Brogna
• Broken People Need Therapy LLC
• Broken Silence, Inc.
• Broken to Art LLC
• Brokenshells Consulting LLC
• Thomas Brombacher, D.O.
• Rebecca Elaine Bromley, PHARMD
• Shaira Mae Bronola
• Jennifer Bronsdon
• Charlene Bronson

• Marriage & Family Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Marriage & Family Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.