Individual provider Active NPI

William Sudduth, M ED., MFT

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1053523167
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
01012 MFT Issued in NV
Practice address
4285 N Rancho Dr Ste 130
Las Vegas, NV 89130-3455
Phone
(702) 385-5331
Fax
(702) 385-5678
NPI assigned
May 3, 2007
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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 01012 MFT NV Primary

Addresses

Primary practice location

4285 N Rancho Dr Ste 130
Las Vegas, NV 89130-3455

Mailing address

HC 33 Box 2628
Las Vegas, NV 89124-9271
Phone (702) 385-5331

Other practice location 1

4495 W Hacienda Ave Ste 7
Las Vegas, NV 89118-1541
Phone (702) 385-5331

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
01012 MFTNVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Alternatives for Families and Youth of Nevada, Inc. CurrentSince Feb 21, 2021 Accepting new patients
Specialized Alternatives for Families and Youth of Nevada, Inc. CurrentSince Sep 29, 2019 Accepting new patients

Locations

4285 N Rancho Dr
Ste 130
Las Vegas, NV 89130

Organizations & group practices 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1053523167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 33 BOX 2628",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891249271",
            "telephone_number": "702-385-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 N RANCHO DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303455",
            "telephone_number": "702-385-5331",
            "fax_number": "702-385-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4495 W Hacienda Ave Ste 7",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891181541",
            "country_code": "US",
            "telephone_number": "702-385-5331",
            "fax_number": "702-385-5678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "WILLIAM",
        "credential": "M ED., MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01012 MFT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.