Individual provider Active NPI

Katelyn Lopez, LMFT

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1083987531
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4192 Issued in NV
Practice address
5412 Boulder Hwy
Las Vegas, NV 89122-6039
Phone
(702) 291-7121
NPI assigned
Feb 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4192 NV Primary

Addresses

Primary practice location

5412 Boulder Hwy
Las Vegas, NV 89122-6039

Mailing address

5412 Boulder Hwy
Las Vegas, NV 89122-6039
Phone (702) 291-7121

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
I20240119002677 NV Practitioner - Marriage and Family Therapist 0042662504 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4192NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Nevada CurrentSince Jan 1, 2024 Accepting new patients

Locations

1401 N Green Valley Pkwy
Ste 260
Henderson, NV 89074
Phone (559) 556-4748

9855 Double R Blvd
Ste 110
Reno, NV 89521

Organizations & group practices 1

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": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1083987531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 BOULDER HWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226039",
            "telephone_number": "702-291-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 BOULDER HWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891226039",
            "telephone_number": "702-291-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "KATELYN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "4192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.