Individual provider Active NPI

Virgilio Desio, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1073764239
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6200-C Issued in NV
Practice address
1000 S Rainbow Blvd
Las Vegas, NV 89145-6231
Phone
(702) 479-4881
Fax
(702) 966-8662
NPI assigned
Oct 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 076106 NY
Clinical Social Worker 1041C0700X 6200-C NV Primary

Addresses

Primary practice location

1000 S Rainbow Blvd
Las Vegas, NV 89145-6231

Mailing address

PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346

Other identifiers 1

IdentifierTypeStateIssuer
1073764239MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170124002038 NV Practitioner - Clinical Social Worker 3274815493 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076106NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Behavioral Services LLC CurrentSince Apr 25, 2023 Accepting new patients
Healthcare Partners Medical Group Coats LTD Current Accepting new patients
Intermountain Medical Holdings Nevada Inc Clinical Past Accepting new patients

Locations

3035 S Maryland Pkwy
Ste 110
Las Vegas, NV 89109
Phone (702) 751-2547

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1073764239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98978",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891938978",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456231",
            "telephone_number": "702-479-4881",
            "fax_number": "702-966-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIO",
        "first_name": "VIRGILIO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076106",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "6200-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073764239",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.