NPIMap

Organization Active NPI

Mindwell Counseling & Crisis Services, LLC

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1205519535
Registry record updated Mar 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MINDWELL COUNSELING & CRISIS SERVICES, LLC
Practice address
2810 W Charleston Blvd Ste 74
Las Vegas, NV 89102
Phone
(725) 291-2700
Fax
(725) 291-2701
NPI assigned
Aug 11, 2023
Last updated
Mar 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2024

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

Authorized official

Name
Jamie KordichNPI 1073920310
Title
Owner
Phone
(702) 358-4894

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Professional Counselor 101YP2500X NU
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

2810 W Charleston Blvd Ste 74
Las Vegas, NV 89102

Mailing address

2810 W Charleston Blvd Ste 74
Las Vegas, NV 89102-1910
Phone (725) 291-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240405000485 NV Part B Supplier - Clinic/Group Practice 6305284688 Receives reassigned benefits from 6 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

2810 W Charleston Blvd
#7374
Las Vegas, NV 89102
Phone (702) 331-2142

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709942400000",
    "number": "1205519535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 W CHARLESTON BLVD STE 74",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021910",
            "telephone_number": "725-291-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W CHARLESTON BLVD STE 74",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89102",
            "telephone_number": "725-291-2700",
            "fax_number": "725-291-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDWELL COUNSELING & CRISIS SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-11",
        "last_updated": "2024-03-09",
        "certification_date": "2024-03-09",
        "status": "A",
        "authorized_official_last_name": "KORDICH",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-358-4894"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 9, 2024; 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.