Organization Active NPI

Desert Peace Therapy LLC

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1073265377
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DESERT PEACE THERAPY LLC
Practice address
2400 N Tenaya Way Ste 301
Las Vegas, NV 89128-0645
Phone
(725) 222-0263
Fax
(725) 262-5630
NPI assigned
Jan 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Alicia Antoinette RunyanNPI 1821641242
Title
Clinical Director
Phone
(725) 222-0263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

2400 N Tenaya Way Ste 301
Las Vegas, NV 89128-0645

Mailing address

2400 N Tenaya Way Ste 301
Las Vegas, NV 89128-0645
Phone (725) 222-0263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250320001190 NV Part B Supplier - Clinic/Group Practice 3476075367 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2400 N Tenaya Way
Ste 301
Las Vegas, NV 89128
Phone (725) 222-0263

2400 N Tenaya Way
Ste 309
Las Vegas, NV 89128
Phone (725) 222-0263

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1073265377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N TENAYA WAY STE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280645",
            "telephone_number": "725-222-0263",
            "fax_number": "725-262-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N TENAYA WAY STE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280645",
            "telephone_number": "725-222-0263",
            "fax_number": "725-262-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT PEACE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "RUNYAN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "725-222-0263"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "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 24, 2025; 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.