Organization Active NPI

Your Choice Behavioral Services, LLC

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1316279185
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
YOUR CHOICE BEHAVIORAL SERVICES, LLC
Practice address
5680 S Pecos Rd Ste 300
Las Vegas, NV 89120-1960
Phone
(702) 538-9474
Fax
(702) 834-8437
NPI assigned
Feb 4, 2010
Last updated
Jan 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Authorized official

Name
Mr. Larry Isaiah ClarkeNPI 1477855260
Title
Ceo
Phone
(702) 538-9474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

5680 S Pecos Rd Ste 300
Las Vegas, NV 89120-1960

Mailing address

5680 S Pecos Rd Ste 300
Las Vegas, NV 89120-1960
Phone (702) 538-9474

Other identifiers 1

IdentifierTypeStateIssuer
1316279185MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160224002718 NV Part B Supplier - Clinic/Group Practice 2466697586 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Your Choice Behavioral Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2755 E Desert Inn Rd
Ste 250
Las Vegas, NV 89121
Phone (702) 538-9474

5680 S Pecos Rd
Ste 300
Las Vegas, NV 89120
Phone (702) 538-9474

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1316279185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 S PECOS RD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201960",
            "telephone_number": "702-538-9474",
            "fax_number": "702-834-8437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 S PECOS RD STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201960",
            "telephone_number": "702-538-9474",
            "fax_number": "702-834-8437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR CHOICE BEHAVIORAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "ISAIAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-538-9474",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316279185",
            "state": "NV"
        }
    ],
    "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 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.