Individual provider Active NPI

Jazmyne Marilee Whitlow

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1124632963
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MI4209 Issued in NV
Practice address
526 S Tonopah Dr Ste 200
Las Vegas, NV 89106-4013
Phone
(702) 440-8440
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NV
Marriage & Family Therapist 106H00000X MI4209 NV Primary

Addresses

Primary practice location

526 S Tonopah Dr Ste 200
Las Vegas, NV 89106-4013

Mailing address

6363 S Pecos Rd Ste 206
Las Vegas, NV 89120-6293
Phone (317) 617-6356

Other practice location 1

6363 S Pecos Rd Ste 206
Las Vegas, NV 89120-6293
Phone (317) 617-6356

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
I20240906001767 NV Order and Referring Only - Marriage and Family Therapist 2860932712

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
University of Nevada, Las Vegas School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3650 Stober Blvd Apt
Suite 193
Las Vegas, NV 89103-1591

4760 S Pecos Rd
Suite 103
Las Vegas, NV 89121-5828

840 S Rancho Dr
4 337
Las Vegas, NV 89106-3837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI4209NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa a Durette MD PLLC Marriage & Family Therapist Past Accepting new patients
Lisa a Durette MD PLLC Marriage & Family Therapist Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1124632963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6363 S PECOS RD STE 206",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891206293",
            "telephone_number": "317-617-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 S TONOPAH DR STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064013",
            "telephone_number": "702-440-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6363 S Pecos Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891206293",
            "country_code": "US",
            "telephone_number": "317-617-6356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLOW",
        "first_name": "JAZMYNE",
        "middle_name": "MARILEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI4209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.