Individual provider Active NPI

Bree Marie Mullin, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Las Vegas, NV
National Provider Identifier
1073687166
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PY0677 Issued in NV
Practice address
3175 E Warm Springs Rd Ste 105
Las Vegas, NV 89120-3137
Phone
(702) 506-4089
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY0677 NV
Clinical Child & Adolescent Psychologist 103TC2200X PY0677 NV Primary

Addresses

Primary practice location

3175 E Warm Springs Rd Ste 105
Las Vegas, NV 89120-3137

Mailing address

3175 E Warm Springs Rd Ste 105
Las Vegas, NV 89120-3137
Phone (702) 506-4089

Other identifiers 1

IdentifierTypeStateIssuer
100525083MedicaidNV

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
PY0677NVMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Solutions for Nevada Clinical Child & Adolescent CurrentSince Sep 11, 2022 Accepting new patients
The Psychology Institute of Las Vegas PLLC CurrentSince Mar 1, 2021 Accepting new patients

Locations

3175 E Warm Springs Rd
Ste 105
Las Vegas, NV 89120
Phone (702) 506-4089

2451 S Buffalo Dr
Ste 120
Las Vegas, NV 89117
Phone (702) 546-9600

1820 E Warm Springs Rd
Ste 115
Las Vegas, NV 89119
Phone (702) 263-0094

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1073687166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 E WARM SPRINGS RD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203137",
            "telephone_number": "702-506-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 E WARM SPRINGS RD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203137",
            "telephone_number": "702-506-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "BREE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY0677",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NV",
            "license": "PY0677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100525083",
            "state": "NV"
        }
    ],
    "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 Oct 2, 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.