Individual provider Active NPI

Gerardo Wence-Munoz, PHD, MA

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1174895874
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3450 E Russell Rd Ste 104
Las Vegas, NV 89120-2201
Phone
(702) 292-7026
NPI assigned
Jan 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3450 E Russell Rd Ste 104
Las Vegas, NV 89120-2201

Mailing address

3450 E Russell Rd Ste 104
Las Vegas, NV 89120-2201
Phone (702) 292-7026

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
I20240131000378 NV Practitioner - Mental Health Counselor 1052764636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bauza Neuropsychiatry Center LLCGroup PAC ID 7618370040, 6 clinicians

Practice addresses (Care Compare)

1601 E Flamingo Rd
Suite 18
Las Vegas, NV 89119-5244
Phone (702) 478-9971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Bauza Neuropsychiatry Center LLC CurrentSince Jan 1, 2024 Accepting new patients
Centro Yolitia LLC Mental Health CurrentSince May 22, 2022 Accepting new patients

Locations

3450 E Russell Rd
Ste 104
Las Vegas, NV 89120
Phone (702) 292-7026

1601 E Flamingo Rd
Ste 18
Las Vegas, NV 89119
Phone (702) 478-9971

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": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1174895874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 E RUSSELL RD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891202201",
            "telephone_number": "702-292-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E RUSSELL RD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891202201",
            "telephone_number": "702-292-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENCE-MUNOZ",
        "first_name": "GERARDO",
        "name_prefix": "Dr.",
        "credential": "PHD, MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-27",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.