Active NPI
Roxana N Monsivais Dominguez
- Mental Health Counselor
- Las Vegas, NV
National Provider Identifier
1104279256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1104279256
- Practice address
- 2920 S Jones Blvd Ste 225
Las Vegas, NV 89146-5622 - Phone
- (702) 476-6395
- NPI assigned
- Jul 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1104279256 | Primary | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Counselor | 101Y00000X | 1104279256 | NV |
Addresses
Primary practice location
2920 S Jones Blvd Ste 225
Las Vegas, NV 89146-5622
Mailing address
764 E Twain Ave Apt 15G
Las Vegas, NV 89169-4127
Phone (702) 334-7769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104279256 | Medicaid | NV |
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 |
|---|---|---|---|
| 1104279256 | NV | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy & Training Centers | Mental Health | Past | Accepting new patients |
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": "1468368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762992000000",
"number": "1104279256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "764 E TWAIN AVE APT 15G",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891694127",
"telephone_number": "702-334-7769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 S JONES BLVD STE 225",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891465622",
"telephone_number": "702-476-6395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONSIVAIS DOMINGUEZ",
"first_name": "ROXANA",
"middle_name": "N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-13",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": "1104279256",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": "NV",
"license": "1104279256",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104279256",
"state": "NV"
}
],
"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 Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.