Individual provider Active NPI

Nicole Marie Deluca

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1205467461
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2675 S Jones Blvd Ste 102
Las Vegas, NV 89146-5607
Phone
(702) 951-9751
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2675 S Jones Blvd Ste 102
Las Vegas, NV 89146-5607

Mailing address

4743 Killington St
Las Vegas, NV 89129-3305
Phone (702) 281-1004

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
I20240403003705 NV Practitioner - Clinical Social Worker 5193163541 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Therapeutic Center LLC Mental Health CurrentSince Feb 27, 2025 Accepting new patients

Locations

3016 W Charleston Blvd
Ste 150
Las Vegas, NV 89102
Phone (702) 412-9077

Organizations & group practices 1

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1205467461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4743 KILLINGTON ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891293305",
            "telephone_number": "702-281-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 S JONES BLVD STE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465607",
            "telephone_number": "702-951-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "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.