Individual provider Active NPI

Amanda Marie Serrano, LMFT

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1215411756
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4242 Issued in NV
Practice address
10620 Southern Highlands Pkwy Ste 110-776
Las Vegas, NV 89141-4371
Phone
(702) 389-7937
NPI assigned
Sep 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MI1076 NV
Marriage & Family Therapist 106H00000X 4242 NV Primary

Addresses

Primary practice location

10620 Southern Highlands Pkwy Ste 110-776
Las Vegas, NV 89141-4371

Mailing address

10620 Southern Highlands Pkwy Ste 110
Las Vegas, NV 89141-4372
Phone (702) 219-5596

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
I20240604002204 NV Practitioner - Marriage and Family Therapist 7012459282 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI1076NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
TRZ NV LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

10620 Southern Highlands Pkwy
Ste 110
Las Vegas, NV 89141
Phone (702) 210-9560

3675 Pecos McLeod
Ste 100
Las Vegas, NV 89121
Phone (702) 389-7937

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": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1215411756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 SOUTHERN HIGHLANDS PKWY STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891414372",
            "telephone_number": "702-219-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 SOUTHERN HIGHLANDS PKWY STE 110-776",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891414371",
            "telephone_number": "702-389-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI1076",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "4242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.