Individual provider Active NPI

Tamekia Flanngan, LCSW

  • Mental Health Counselor
  • Henderson, NV
National Provider Identifier
1336633221
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
111103 Issued in CA
Practice address
1525 Spiced Wine Ave Unit 16101
Henderson, NV 89074-0172
Phone
(951) 236-8415
NPI assigned
Jun 14, 2018
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 111103 CA Primary

Addresses

Primary practice location

1525 Spiced Wine Ave Unit 16101
Henderson, NV 89074-0172

Mailing address

35 E Horizon Ridge Pkwy Ste 110
Henderson, NV 89002-7906
Phone (951) 724-3449

Other practice location 1

6833 Indiana Ave
Riverside, CA 92506-4223
Phone (951) 289-5424

Other identifiers 1

IdentifierTypeStateIssuer
101YM0800XMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240524001024 NV Practitioner - Clinical Social Worker 2062854854 Reassigns benefits to 1 organization
I20240624000505 CA Practitioner - Clinical Social Worker 2062854854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11103CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nebula Health, LLC CurrentSince May 12, 2024 Accepting new patients
Behavioral Health Solutions LLC Mental Health CurrentSince May 13, 2024 Accepting new patients
Next Level Psychiatry Arizona PLLC CurrentSince May 13, 2024 Accepting new patients

Locations

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

5900 Brockton Ave
Riverside, CA 92506
Phone (800) 992-0901

6833 Indiana Ave
Ste 101
Riverside, CA 92506
Phone (657) 346-6319

806 Avenida Pico
#I330
San Clemente, CA 92673

2200 Paseo Verde Pkwy
Ste 190
Henderson, NV 89052
Phone (702) 483-5061

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1336633221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E HORIZON RIDGE PKWY STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890027906",
            "telephone_number": "951-724-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 SPICED WINE AVE UNIT 16101",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890740172",
            "telephone_number": "951-236-8415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6833 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925064223",
            "country_code": "US",
            "telephone_number": "951-289-5424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLANNGAN",
        "first_name": "TAMEKIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "111103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.