Individual provider Active NPI

Ivette Stephanie Garcia Retirado

  • Behavior Technician
  • Las Vegas, NV
National Provider Identifier
1134627276
Registry record updated Jun 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1591 E Desert Inn Rd
Las Vegas, NV 89169
Phone
(702) 202-0291
NPI assigned
Jan 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1591 E Desert Inn Rd
Las Vegas, NV 89169

Mailing address

1591 E Desert Inn Rd
Las Vegas, NV 89169-2502
Phone (702) 525-6889

Other practice location 1

9029 S Pecos Rd Ste 2700
Henderson, NV 89074-7198
Phone (702) 778-4500

Other practice location 2

408 S Jones Blvd
Las Vegas, NV 89107-2658
Phone (702) 502-8021 ext. 702

Other practice location 3

408 S Jones Blvd
Las Vegas, NV 89107-2658
Phone (702) 502-8021 ext. 702

Other practice location 4

4550 W Oakey Blvd Ste 108A
Las Vegas, NV 89102-1506
Phone (702) 470-5252

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

Practice roles

OrganizationSpecialtyStatusNew patients
Individualized Mindful Solutions LLC Current Accepting new patients
Ims Behavioral Health LLC PastSince Aug 1, 2019 Accepting new patients
Ims Behavioral Health LLC Past Accepting new patients

Organizations & group practices 3

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": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559952000000",
    "number": "1134627276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 E DESERT INN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692502",
            "telephone_number": "702-525-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 E DESERT INN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89169",
            "telephone_number": "702-202-0291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9029 S Pecos Rd Ste 2700",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890747198",
            "country_code": "US",
            "telephone_number": "702-778-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "408 S Jones Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891072658",
            "country_code": "US",
            "telephone_number": "702-502-8021 x702",
            "fax_number": "888-688-9464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "408 S Jones Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891072658",
            "country_code": "US",
            "telephone_number": "702-502-8021 x702",
            "fax_number": "888-688-9464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4550 W Oakey Blvd Ste 108A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021506",
            "country_code": "US",
            "telephone_number": "702-470-5252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RETIRADO",
        "first_name": "IVETTE STEPHANIE",
        "middle_name": "GARCIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2019-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "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 8, 2019; 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.