Individual provider Active NPI

Serena Rogers

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1093402398
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4485 S Buffalo Dr # E
Las Vegas, NV 89147-5006
Phone
(702) 888-6300
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NV Primary

Addresses

Primary practice location

4485 S Buffalo Dr # E
Las Vegas, NV 89147-5006

Mailing address

610 Landview CT
Las Vegas, NV 89123-0195
Phone (410) 419-4919

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
I20260427001496 NV Practitioner - Mental Health Counselor 1153898267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1607 Willowmill Lane
Suite 300
Las Vegas, NV 89123-1910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theravada Mental Health LLC CurrentSince Mar 4, 2026 Accepting new patients

Locations

2445 Fire Mesa St
Ste 270
Las Vegas, NV 89128
Phone (702) 212-3008

1607 E Windmill Ln
Ste 300
Las Vegas, NV 89123
Phone (702) 757-8720

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": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1093402398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 LANDVIEW CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891230195",
            "telephone_number": "410-419-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 S BUFFALO DR # E",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891475006",
            "telephone_number": "702-888-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SERENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.