Individual provider Active NPI

John James Manolakos

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1356606339
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5130 S Pecos Rd
Apt/Suite 2B
Las Vegas, NV 89120-1248
Phone
(702) 900-7397
Fax
(888) 753-3302
NPI assigned
Jul 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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 Primary

Addresses

Primary practice location

5130 S Pecos Rd
Apt/Suite 2B
Las Vegas, NV 89120-1248

Mailing address

6908 Gothic Marigold St
Las Vegas, NV 89149-3013
Phone (702) 541-1873

Other identifiers 1

IdentifierTypeStateIssuer
900837799MedicaidNV

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

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1356606339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6908 GOTHIC MARIGOLD ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891493013",
            "telephone_number": "702-541-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 S PECOS RD",
            "address_2": "APT/SUITE 2B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201248",
            "telephone_number": "702-900-7397",
            "fax_number": "888-753-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOLAKOS",
        "first_name": "JOHN",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "900837799",
            "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 Jul 6, 2012; 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.