Serenity Mind Spa

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

101YP2500X Issued in NV

Legal business name

SERENITY MIND SPA

Practice address

7495 W Azure Dr Ste 237
Las Vegas, NV 89130-4437

Phone

(702) 680-9350

NPI assigned

Feb 1, 2018

Last updated

Jun 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. La Toya Williams, QMHP

Title

CPC-I

Phone

(702) 680-9350

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1265930549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7495 W AZURE DR STE 237",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304437",
            "telephone_number": "702-680-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7495 W AZURE DR STE 237",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304437",
            "telephone_number": "702-680-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY MIND SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LA TOYA",
        "authorized_official_title_or_position": "CPC-I",
        "authorized_official_telephone_number": "702-680-9350",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "QMHP"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "101YP2500X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871897967",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15982110047",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Serenity One Behavioral Health Care, LLC. (Serenity One Behavioral Health Care)
• Serenity Personal Care LLC
• Serenity Personal Care LLC
• Serenity Personal Care LLC

• Professional Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.