Individual provider Active NPI

Melissa A Hildebrand, CPC-I, CADC-I

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1306252762
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CI1755 Issued in NV
Practice address
3468 Blue Heather Dr
Las Vegas, NV 89129-6360
Phone
(702) 812-9268
Fax
(702) 924-7416
NPI assigned
Jul 7, 2014
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 06941-1 NV
Mental Health Counselor 101YM0800X CI1755 NV Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

3468 Blue Heather Dr
Las Vegas, NV 89129-6360

Mailing address

3468 Blue Heather Dr
Las Vegas, NV 89129-6360
Phone (702) 812-9268

Other practice location 1

2921 N Tenaya Way
Las Vegas, NV 89128-1409
Phone (702) 812-9268

Other practice location 2

3550 W Cheyenne Ave
130
North Las Vegas, NV 89032-8212
Phone (702) 570-5200

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
I20240119001649 NV Practitioner - Other (Non-Physician) 0941652473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Health and Wellness LLCGroup PAC ID 9335363118, 11 clinicians

Practice addresses (Care Compare)

2921 N Tenaya Way
Las Vegas, NV 89128-1409
Phone (702) 338-8373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06941-1NVMDAddiction (Substance Use Disorder) Counselor
CI1755NVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Health and Wellness, LLC CurrentSince Jan 1, 2024 Accepting new patients
Legacy Health and Wellness, LLC CurrentSince Jan 1, 2024 Accepting new patients
Brooks Behavioral Health Center LLC PastSince Jun 1, 2015 Accepting new patients

Locations

2921 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 338-8373

2921 N Tenaya Way
Ste 126
Las Vegas, NV 89128

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1306252762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3468 BLUE HEATHER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296360",
            "telephone_number": "702-812-9268",
            "fax_number": "702-924-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 BLUE HEATHER DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296360",
            "telephone_number": "702-812-9268",
            "fax_number": "702-924-7416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2921 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891281409",
            "country_code": "US",
            "telephone_number": "702-812-9268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3550 W Cheyenne Ave",
            "address_2": "130",
            "address_purpose": "LOCATION",
            "city": "North Las Vegas",
            "state": "NV",
            "postal_code": "890328212",
            "country_code": "US",
            "telephone_number": "702-570-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILDEBRAND",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "CPC-I, CADC-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "06941-1",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CI1755",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.