Organization Active NPI

Simple Life Solutions LLC

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1194338061
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SIMPLE LIFE SOLUTIONS LLC
Practice address
5510 S. Ft. Apache Rd
#220
Las Vegas, NV 89148
Phone
(702) 858-6455
Fax
(702) 442-9615
NPI assigned
Aug 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Paula Shannon, LPC, LMFT, LCADCNPI 1275937252
Title
Manager/Owner
Phone
(501) 352-4178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

5510 S. Ft. Apache Rd
#220
Las Vegas, NV 89148

Mailing address

PO Box 280
Benton, AR 72018-0280
Phone (501) 352-4178

Other practice location 1

17724 I 30 Ste 2
Benton, AR 72019-2961
Phone (501) 352-4178

Other identifiers 3

IdentifierTypeStateIssuer
330740719MedicaidAR
250004786MedicaidNV
71853MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260625005007 AR Part B Supplier - Clinic/Group Practice 5597238923 Receives reassigned benefits from 1 practitioner
Practice locations: Benton, AR

National Provider Directory

National Provider Directory

Locations

17724 I 30
Ste 2
Benton, AR 72019
Phone (501) 352-4178

5510 S Fort Apache Rd
#220
Las Vegas, NV 89148
Phone (702) 858-6455

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1194338061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720180280",
            "telephone_number": "501-352-4178",
            "fax_number": "702-442-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 S. FT. APACHE RD",
            "address_2": "#220",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "702-858-6455",
            "fax_number": "702-442-9615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17724 I 30 Ste 2",
            "address_purpose": "LOCATION",
            "city": "Benton",
            "state": "AR",
            "postal_code": "720192961",
            "country_code": "US",
            "telephone_number": "501-352-4178",
            "fax_number": "702-442-9615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIMPLE LIFE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "501-352-4178",
        "authorized_official_credential": "LPC, LMFT, LCADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330740719",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250004786",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71853",
            "state": "NV"
        }
    ],
    "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 Mar 4, 2025; 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.