Individual provider Active NPI

Oyibo Igboamazu

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1063914927
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
6034 Smoke Ranch Rd
Las Vegas, NV 89108-3700
Phone
(702) 219-5283
NPI assigned
Mar 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 07436-LCJ NV
Marriage & Family Therapist 106H00000X Primary
Personal Care Attendant 3747P1801X

Addresses

Primary practice location

6034 Smoke Ranch Rd
Las Vegas, NV 89108-3700

Mailing address

2112 Interbay St
Las Vegas, NV 89128-6502
Phone (702) 327-9012

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
07436-LCJNVMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
P&P Mental Health Services Inc Marriage & Family Therapist CurrentSince Dec 3, 2023 Accepting new patients
Princess Personal Care , LLC Current Accepting new patients
Omega Therapy & Counseling LLC Marriage & Family Therapist CurrentSince Dec 3, 2023 Accepting new patients

Locations

6034 Smoke Ranch Rd
Las Vegas, NV 89108
Phone (702) 219-5283

Organizations & group practices 3

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": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1063914927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 INTERBAY ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891286502",
            "telephone_number": "702-327-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6034 SMOKE RANCH RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891083700",
            "telephone_number": "702-219-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGBOAMAZU",
        "first_name": "OYIBO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07436-LCJ",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 15, 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.