Active NPI
Annelisia Chacon
- Marriage & Family Therapist
- North Las Vegas, NV
National Provider Identifier
1275228413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MI4234
- Practice address
- 4538 W Craig Rd Ste 290
North Las Vegas, NV 89032-2511 - Phone
- (702) 486-6987
- NPI assigned
- Apr 5, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | MI4234 | NV | Primary |
Addresses
Primary practice location
4538 W Craig Rd Ste 290
North Las Vegas, NV 89032-2511
Mailing address
3920 W Ann Rd Ste 100
North Las Vegas, NV 89031-3840
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 |
|---|---|---|---|
| MI4234 | NV | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1275228413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3920 W ANN RD STE 100",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890313840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4538 W CRAIG RD STE 290",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890322511",
"telephone_number": "702-486-6987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACON",
"first_name": "ANNELISIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-05",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NV",
"license": "MI4234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.