Active NPI
Kimberly Ann Callahan
- Mental Health Counselor
- Las Vegas, NV
National Provider Identifier
1255631628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CI0109
- Practice address
- 3670 N Rancho Dr
Suite 105
Las Vegas, NV 89130-3174 - Phone
- (702) 432-6463
- NPI assigned
- Nov 1, 2010
- Last updated
- May 12, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CI0109 | NV | Primary |
Addresses
Primary practice location
3670 N Rancho Dr
Suite 105
Las Vegas, NV 89130-3174
Mailing address
3670 N Rancho Dr
Suite 105
Las Vegas, NV 89130-3174
Phone (702) 432-6463
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 |
|---|---|---|---|
| CI0109 | NV | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494547200000",
"number": "1255631628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3670 N RANCHO DR",
"address_2": "SUITE 105",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891303174",
"telephone_number": "702-432-6463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3670 N RANCHO DR",
"address_2": "SUITE 105",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891303174",
"telephone_number": "702-432-6463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAHAN",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-01",
"last_updated": "2017-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CI0109",
"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 May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.