Candlelight Mental Health Counseling Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CANDLELIGHT MENTAL HEALTH COUNSELING CENTER LLC

Practice address

5258 S Eastern Ave Ste 105
Las Vegas, NV 89119-2327

Phone

(702) 464-5080

NPI assigned

May 22, 2019

Organization subpart

No

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

Authorized official

Name

Shiba Neomi Amezcua

Title

Ceo

Phone

(702) 738-9064

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1164089488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ROCKY TRAIL RD",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890140321",
            "telephone_number": "702-738-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5258 S EASTERN AVE STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891192327",
            "telephone_number": "702-464-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDLELIGHT MENTAL HEALTH COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "AMEZCUA",
        "authorized_official_first_name": "SHIBA",
        "authorized_official_middle_name": "NEOMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-738-9064"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NV20191376022",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Michelle Candido
• Rosa Candido
• Yovie Canding
• Phillip Candland
• Candlelight Counseling Center
• Deangelo L Candler
• Mar'Kyi Candler
• Candy Hair LLC
• Nicole Canedo, CSWI
• Nancy Lizet Canela

• Mental Health Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.