Active NPI
Clarissa Moreno
- Counselor
- Las Vegas, NV
National Provider Identifier
1083080048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 01646-I
- Practice address
- 1640 Alta Dr Ste 4
Las Vegas, NV 89106-4165 - Phone
- (702) 474-6450
- Fax
- (702) 474-6463
- NPI assigned
- Aug 13, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 01646-I | NV | Primary |
Addresses
Primary practice location
1640 Alta Dr Ste 4
Las Vegas, NV 89106-4165
Mailing address
1640 Alta Dr Ste 4
Las Vegas, NV 89106-4165
Phone (702) 474-6450
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01646-I | NV | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridge Counseling Associates, Inc | Past | Accepting new patients | |
| There Is No Hero in Heroin (Tinhih) | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/f9a6475a-3dbd-47b2-979a-55064cfdbd51/
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.
-
- Community/Behavioral Health Agency
- Las Vegas, NV
- NPI 1447714076
-
- Substance Abuse Rehabilitation Facility
- Las Vegas, NV
- NPI 1407483456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1083080048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 ALTA DR STE 4",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064165",
"telephone_number": "702-474-6450",
"fax_number": "702-474-6463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 ALTA DR STE 4",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064165",
"telephone_number": "702-474-6450",
"fax_number": "702-474-6463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "CLARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-13",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NV",
"license": "01646-I",
"primary": true
}
],
"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 Aug 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.