Active NPI
Discovery Mind & Wellness Center
- Psychologist
- Las Vegas, NV
National Provider Identifier
1073963807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Legal business name
- DISCOVERY MIND & WELLNESS CENTER
- Practice address
- 2920 S Jones Blvd
#220
Las Vegas, NV 89146-5642 - Phone
- (702) 968-9372
- NPI assigned
- Jun 13, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Charles Stolberg IV, M.S.
- Title
- Clinican
- Phone
- (702) 968-9372
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
2920 S Jones Blvd
#220
Las Vegas, NV 89146-5642
Mailing address
2920 S Jones Blvd
#220
Las Vegas, NV 89146-5642
Phone (702) 968-9372
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487997805 | Medicaid | NV |
National Provider Directory
National Provider Directory- Tax ID family
- Discovery Mind and Wellness
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Las Vegas, NV
- NPI 1487997805
-
- Community/Behavioral Health Agency
- Las Vegas, NV
- NPI 1255784625
-
- Health Maintenance Organization
- Boulder City, NV
- NPI 1700213857
Locations
2920 S Jones Blvd
Ste 220
Las Vegas, NV 89146
Phone (702) 321-5062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465776000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1465776000000",
"number": "1073963807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2920 S JONES BLVD",
"address_2": "#220",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891465642",
"telephone_number": "702-968-9372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 S JONES BLVD",
"address_2": "#220",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891465642",
"telephone_number": "702-968-9372"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DISCOVERY MIND & WELLNESS CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2016-06-13",
"last_updated": "2016-06-13",
"status": "A",
"authorized_official_last_name": "STOLBERG",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "CLINICAN",
"authorized_official_telephone_number": "702-968-9372",
"authorized_official_name_suffix": "IV",
"authorized_official_credential": "M.S."
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1487997805",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
- Stephen Vincent Disabatino, M.D.
- Andrew Joseph Disavino, PSY.D.
- Discount Pharmacy LLC
- Discovery 2000, Mersha P.C. (Discovery Dental)
- Discovery ABA NV LLC (Treetop Therapy NV LLC)
- Discovery Mind & Wellness Center, LLC
- Discovery Mind and Wellness
- Discovery Mind Center LTD
- Discovery Mind Center LTD
- Kayla Dishman
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.