Individual provider Active NPI

Deanna Marie Weston

  • Social Worker
  • Las Vegas, NV
National Provider Identifier
1356059034
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
11855-M Issued in NV
Practice address
510 N Fogg St
Las Vegas, NV 89110
Phone
(360) 239-4089
NPI assigned
Nov 10, 2022
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11855-M NV Primary

Addresses

Primary practice location

510 N Fogg St
Las Vegas, NV 89110

Mailing address

510 N Fogg St
Las Vegas, NV 89110
Phone (360) 239-4089

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
11855-MNVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Self Sufficiency Behavioral Health LLC PastSince Nov 1, 2022 Accepting new patients

Organizations & group practices 1

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": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1356059034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N FOGG ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89110",
            "telephone_number": "360-239-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N FOGG ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89110",
            "telephone_number": "360-239-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON",
        "first_name": "DEANNA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "11855-M",
            "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 Oct 16, 2024; 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.