Active NPI
Patricia C Poblete, LCSW
- Clinical Social Worker
- Las Vegas, NV
National Provider Identifier
1356490684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8784-C
- Practice address
- 1809 Snow Spring LN
Las Vegas, NV 89134-2551 - Phone
- (725) 270-7759
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 27602 | CA | |
| Clinical Social Worker | 1041C0700X | 8784-C | NV | Primary |
Addresses
Primary practice location
1809 Snow Spring LN
Las Vegas, NV 89134-2551
Mailing address
1930 Village Center Cir # 3239
Las Vegas, NV 89134-6299
Phone (510) 224-0103
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27602 | Other | CA | BBS |
| 8784-C | Other | NV | STATE OF NEVADA BOARD OF EXAMINERS FOR SOCIAL WORKERS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8784-C | NV | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666396800000",
"number": "1356490684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 VILLAGE CENTER CIR # 3239",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891346299",
"telephone_number": "510-224-0103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 SNOW SPRING LN",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891342551",
"telephone_number": "725-270-7759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POBLETE",
"first_name": "PATRICIA",
"middle_name": "C",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2022-10-22",
"certification_date": "2022-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "27602",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "8784-C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BBS",
"identifier": "27602",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF NEVADA BOARD OF EXAMINERS FOR SOCIAL WORKERS",
"identifier": "8784-C",
"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 Oct 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.