Enoch Sackey, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61421638 Issued in WA

Practice address

2320 Paseo del Prado Ste B208
Las Vegas, NV 89102-4332

Phone

(702) 685-0877

Fax

(702) 749-5922

NPI assigned

Dec 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Insight Therapy Solutions LLC

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1639414279

  Clinical

  NPD
• Insight Medical Clinicians PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
  • NPI 1003633603

  Clinical

  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation

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

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1043088925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E SUNSET RD # 5-823",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203511",
            "telephone_number": "702-685-0877",
            "fax_number": "702-749-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 PASEO DEL PRADO STE B208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024332",
            "telephone_number": "702-685-0877",
            "fax_number": "702-749-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKEY",
        "first_name": "ENOCH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61421638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sachele Senior Guest Home II
• Zarine D Sachinvala, OTR
• Andrea Lynn Sachs
• David I Sack, MD
• Emily K Sackett, RBT
• Michelle Sackmann
• Alan Jeffrey Sacks, MD
• Andrea Marie Sacks, DDS
• Sacred Heart Diagnostics Center, Incorporated
• Sacred Heart Homecare Services, Inc.

• Clinical Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.