Individual provider Active NPI

Courtney L Pruitt, LMSW

  • Social Worker
  • Las Vegas, NV
National Provider Identifier
1174342182
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
11869-M Issued in NV
Practice address
4285 N Rancho Dr Ste 130
Las Vegas, NV 89130-3455
Phone
(702) 385-5331
Fax
(702) 385-5678
NPI assigned
Oct 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11869-M NV Primary

Addresses

Primary practice location

4285 N Rancho Dr Ste 130
Las Vegas, NV 89130-3455

Mailing address

10100 Elida Rd
Delphos, OH 45833-9056
Phone (419) 695-8010

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

LicenseStateTypeSpecialty
11869-MNVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Alternatives for Families and Youth of Nevada, Inc. CurrentSince Oct 13, 2024 Accepting new patients
Specialized Alternatives for Families and Youth of Nevada, Inc. CurrentSince Oct 13, 2024 Accepting new patients

Locations

4285 N Rancho Dr
Ste 130
Las Vegas, NV 89130

10100 Elida Rd
Delphos, OH 45833
Phone (419) 685-8010

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": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1174342182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 ELIDA RD",
            "city": "DELPHOS",
            "state": "OH",
            "postal_code": "458339056",
            "telephone_number": "419-695-8010",
            "fax_number": "419-695-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 N RANCHO DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303455",
            "telephone_number": "702-385-5331",
            "fax_number": "702-385-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "COURTNEY",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "11869-M",
            "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 Oct 7, 2024; 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.