Individual provider Active NPI

Mignon Elizabeth Pasqualicchio, MFT

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1255401600
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
01023 Issued in NV
Practice address
6171 W Charleston Blvd Ste 16
8205 Fawn Brook Court, LV, NV 89149
Las Vegas, NV 89146-1126
Phone
(702) 486-6136
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 01023 NV Primary

Addresses

Primary practice location

6171 W Charleston Blvd Ste 16
8205 Fawn Brook Court, LV, NV 89149
Las Vegas, NV 89146-1126

Mailing address

6171 W Charleston Blvd
Las Vegas, NV 89146-1126
Phone (702) 486-6136

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

LicenseStateTypeSpecialty
01023NVMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1255401600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6171 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461126",
            "telephone_number": "702-486-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6171 W CHARLESTON BLVD STE 16",
            "address_2": "8205 FAWN BROOK COURT, LV, NV 89149",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461126",
            "telephone_number": "702-486-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASQUALICCHIO",
        "first_name": "MIGNON",
        "middle_name": "ELIZABETH",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01023",
            "primary": true
        }
    ],
    "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 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.