Individual provider Active NPI

Roberto Ruiz Valdez, LCADC, LCPC

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1275822652
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CP029 Issued in NV
Practice address
714 E Sahara Ave
Las Vegas, NV 89104-2942
Phone
(702) 369-8700
Fax
(702) 369-8489
NPI assigned
Apr 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CP029 NV Primary

Addresses

Primary practice location

714 E Sahara Ave
Las Vegas, NV 89104-2942

Mailing address

714 E Sahara Ave
Las Vegas, NV 89104-2942
Phone (702) 292-0397

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL rvaldez@cccofsn.org Health Information Exchange (HIE)

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
I20260618001878 NV Practitioner - Mental Health Counselor 3779055934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Nevada, Las Vegas School of Medicine, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3311 S Rainbow Blvd
Suite 105
Las Vegas, NV 89146-6596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP029NVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Center Past Accepting new patients

Organizations & group practices 2

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": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1275822652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891042942",
            "telephone_number": "702-292-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891042942",
            "telephone_number": "702-369-8700",
            "fax_number": "702-369-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "ROBERTO",
        "middle_name": "RUIZ",
        "credential": "LCADC, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2021-08-26",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rvaldez@cccofsn.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "714 E Sahara Ave",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891042942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.