MLC Therapy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

4509 Issued in KS

Legal business name

MLC THERAPY LLC

Practice address

810 Fireweed Dr
Henderson, NV 89002-9105

Phone

(913) 562-8880

Fax

(702) 445-6075

NPI assigned

Sep 11, 2017

Organization subpart

No

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

Authorized official

Name

Marie L Cook, LCSWNPI 1912284274

Title

Director

Phone

(913) 562-8880

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie L Cook, LCSW

  • Clinical Social Worker
  • Henderson, NV
  • NPI 1912284274
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1154840247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 FIREWEED DRIVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89002",
            "telephone_number": "913-562-8880",
            "fax_number": "702-445-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FIREWEED DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890029105",
            "telephone_number": "913-562-8880",
            "fax_number": "702-445-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "913-562-8880",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KS",
            "license": "4509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lior Mitnik
• Jhansi Mitra-Chakraborty, PT, MA, MHA
• Jonathan Jacob Mix
• Bob Kyo Miyake, MD
• Ryan Mizoguchi
• MLM Medical Services PLLC
• Mno Enterprises
• Ashley Mo, MD
• Kelsey Nicole Moakler, PA-C
• Mobile Medical Solutions

• Community/Behavioral Health Agency in Henderson, NV
• Providers in Henderson, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.