NPIMap

Organization Active NPI

Eagle Mind Health Services LLC

  • Counseling Psychologist
  • Las Vegas, NV
National Provider Identifier
1306456181
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
EAGLE MIND HEALTH SERVICES LLC
Practice address
1250 Burnham Ave
Las Vegas, NV 89104-1921
Phone
(702) 331-9842
NPI assigned
Aug 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Mrs. Caroline Ugbodu, MFT
Title
Director
Phone
(702) 772-0597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

1250 Burnham Ave
Las Vegas, NV 89104-1921

Mailing address

1250 Burnham Ave
Las Vegas, NV 89104-1921
Phone (702) 331-9842

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1306456181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 BURNHAM AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041921",
            "telephone_number": "702-331-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BURNHAM AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041921",
            "telephone_number": "702-331-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MIND HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "UGBODU",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-772-0597",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "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 Aug 11, 2020; 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.