Individual provider Active NPI

Robert Soucy, LPC, LCPC, LPCC

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1053850636
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0017386 Issued in CO
Practice address
2121 W Charleston Blvd
Las Vegas, NV 89102
Phone
(702) 382-7746
NPI assigned
Feb 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00529-LC NV
Mental Health Counselor 101YM0800X CTB-2023-0648 NM
Mental Health Counselor 101YM0800X LPC-21334 AZ
Mental Health Counselor 101YM0800X 202234677 MO
Mental Health Counselor 101YM0800X CP5078-R NV
Mental Health Counselor 101YM0800X LPC.0017386 CO Primary

Addresses

Primary practice location

2121 W Charleston Blvd
Las Vegas, NV 89102

Mailing address

8732 Autumn Valley Ave
Las Vegas, NV 89129-7618
Phone (505) 210-6098

Other practice location 1

2441 Cabezon Blvd SE
Rio Rancho, NM 87124-1576
Phone (505) 717-1155

Other practice location 2

6655 W Sahara Ave Ste B200
Las Vegas, NV 89146-2832
Phone (702) 629-6982

Other practice location 3

2121 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 382-7746

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
00529-LCNVMDAddiction (Substance Use Disorder) Counselor
LPC-21334AZMDMental Health Counselor
LPC.0017386COMDMental Health Counselor
202234677MOMDMental Health Counselor
CTB-2023-0648NMMDMental Health Counselor
CP5078-RNVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Connection LLC Past Accepting new patients
Charleston Residential Services LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1053850636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8732 AUTUMN VALLEY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297618",
            "telephone_number": "505-210-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "702-382-7746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2441 Cabezon Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871241576",
            "country_code": "US",
            "telephone_number": "505-717-1155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6655 W Sahara Ave Ste B200",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891462832",
            "country_code": "US",
            "telephone_number": "702-629-6982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89102",
            "country_code": "US",
            "telephone_number": "702-382-7746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUCY",
        "first_name": "ROBERT",
        "credential": "LPC, LCPC, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-16",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "00529-LC",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2023-0648",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-21334",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "202234677",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP5078-R",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0017386",
            "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 Aug 11, 2025; 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.