Active NPI
Jaime Maldonado
- Clinical Social Worker
- Las Vegas, NV
National Provider Identifier
1336294461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7769-C
- Practice address
- 2701 Renwick Cir
Las Vegas, NV 89117-0405 - Phone
- (413) 626-6225
- Fax
- (702) 982-3260
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 13320 | MA | |
| Clinical Social Worker | 1041C0700X | 120382 | MA | |
| Clinical Social Worker | 1041C0700X | 7769-C | NV | Primary |
Addresses
Primary practice location
2701 Renwick Cir
Las Vegas, NV 89117-0405
Mailing address
8635 W Sahara Ave # 479
Las Vegas, NV 89117-5858
Phone (413) 626-6225
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120382 | MA | MD | Clinical Social Worker |
| 7769-C | NV | MD | Clinical Social Worker |
| 13320 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515024000000",
"number": "1336294461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8635 W SAHARA AVE # 479",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891175858",
"telephone_number": "413-626-6225",
"fax_number": "702-982-3260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 RENWICK CIR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891170405",
"telephone_number": "413-626-6225",
"fax_number": "702-982-3260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "JAIME",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2018-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "13320",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "120382",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "7769-C",
"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 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.