Individual provider Active NPI

Vincent Nmi Rodriguez, PHD

  • Professional Counselor
  • Las Vegas, NV
National Provider Identifier
1346473154
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CI0324 Issued in NV
Practice address
2740 S Jones Blvd
Las Vegas, NV 89146-5398
Phone
(702) 248-8866
NPI assigned
Aug 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X CI0324 NV Primary

Addresses

Primary practice location

2740 S Jones Blvd
Las Vegas, NV 89146-5398

Mailing address

10280 Gaeta PL
Las Vegas, NV 89134-2603
Phone (702) 762-0588

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
CI0324NVMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1346473154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10280 GAETA PL",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891342603",
            "telephone_number": "702-762-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465398",
            "telephone_number": "702-248-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "VINCENT",
        "middle_name": "NMI",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI0324",
            "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 Sep 27, 2021; 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.