Active NPI
Alan Paul Raddatz, MSW,BCD
- Clinical Social Worker
- Las Vegas, NV
National Provider Identifier
1194880674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SNV LCSW 00131-C
- Practice address
- 6960 Obannon Dr Ste 190
Las Vegas, NV 89117 - Phone
- (702) 320-3180
- Fax
- (702) 320-3180
- NPI assigned
- Dec 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SNV LCSW 00131-C | NV | Primary |
Addresses
Primary practice location
6960 Obannon Dr Ste 190
Las Vegas, NV 89117
Mailing address
6960 Obannon Dr Ste 190
Las Vegas, NV 89117-2158
Phone (702) 320-3180
Other practice location 1
7530 W Sahara Ave
Suite 103
Las Vegas, NV 89117-2744
Phone (702) 320-3180
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194880674 | Medicaid | NV | |
| LADC0772L | Other | NV | LICENSED DRUG AND ALCOHOL |
| 1041C0700X | Other | NV | LCSW |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SNV LCSW 00131-C | NV | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558396800000",
"number": "1194880674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6960 OBANNON DR STE 190",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891172158",
"telephone_number": "702-320-3180",
"fax_number": "702-320-3180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6960 OBANNON DR STE 190",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89117",
"telephone_number": "702-320-3180",
"fax_number": "702-320-3180"
}
],
"practiceLocations": [
{
"address_1": "7530 W Sahara Ave",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891172744",
"country_code": "US",
"telephone_number": "702-320-3180",
"fax_number": "702-320-3180",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RADDATZ",
"first_name": "ALAN",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "MSW,BCD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2019-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "SNV LCSW 00131-C",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194880674",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED DRUG AND ALCOHOL",
"identifier": "LADC0772L",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "1041C0700X",
"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 May 21, 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.