Organization Active NPI

Liberty Behavioral Consultants

  • Counselor
  • Las Vegas, NV
National Provider Identifier
1083901060
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
LIBERTY BEHAVIORAL CONSULTANTS
Practice address
4760 S Pecos Rd # 200-9
Las Vegas, NV 89121-5828
Phone
(702) 768-3076
NPI assigned
Jun 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Authorized official

Name
Myesha Wilson
Title
Coo
Phone
(702) 768-3076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

4760 S Pecos Rd # 200-9
Las Vegas, NV 89121-5828

Mailing address

4760 S Pecos Rd # 200-9
Las Vegas, NV 89121-5828

National Provider Directory

National Provider Directory

Locations

4760 S Pecos Rd
#2009
Las Vegas, NV 89121
Phone (702) 768-3076

Practitioners & affiliated clinicians

Practitioners 3

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": "1309305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1083901060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD # 200-9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD # 200-9",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215828",
            "telephone_number": "702-768-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY BEHAVIORAL CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MYESHA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "702-768-3076"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "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 Jun 29, 2011; 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.