Individual provider Active NPI

Brett Wayne Zupan

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1316219777
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
2820 W Charleston Blvd
Ste. C28
Las Vegas, NV 89102-1942
Phone
(702) 675-3850
Fax
(702) 901-7596
NPI assigned
Feb 1, 2012
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MI0691 NV
Rehabilitation Practitioner 225400000X
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

2820 W Charleston Blvd
Ste. C28
Las Vegas, NV 89102-1942

Mailing address

2120 Alamo Heights Ave
North Las Vegas, NV 89031-3818
Phone (702) 354-9684

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

LicenseStateTypeSpecialty
MI0691NVMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1316219777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 ALAMO HEIGHTS AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890313818",
            "telephone_number": "702-354-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W CHARLESTON BLVD",
            "address_2": "STE. C28",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021942",
            "telephone_number": "702-675-3850",
            "fax_number": "702-901-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUPAN",
        "first_name": "BRETT",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-01",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "MI0691",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "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 Jan 24, 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.