Individual provider Active NPI

Leilani Rena Puentes, PH.D.

  • Clinical Psychologist
  • Las Vegas, NV
National Provider Identifier
1356736474
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PA132 Issued in NV
Practice address
7341 W Charleston Blvd Ste 150
Las Vegas, NV 89117-1578
Phone
(702) 268-8542
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X OR
Clinical Psychologist 103TC0700X PA132 NV Primary

Addresses

Primary practice location

7341 W Charleston Blvd Ste 150
Las Vegas, NV 89117-1578

Mailing address

849 Pacific Ave
Hood River, OR 97031-1956
Phone (541) 386-6380

Other names 1

  • Mrs. Leilani Rena Chavez Former name

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
PA132NVMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver State Psychology CurrentSince Sep 1, 2024 Accepting new patients
Silver State Psychology CurrentSince Sep 1, 2024 Accepting new patients

Locations

7341 W Charleston Blvd
Ste 150
Las Vegas, NV 89117
Phone (702) 268-8542

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1356736474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 PACIFIC AVE",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311956",
            "telephone_number": "541-386-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7341 W CHARLESTON BLVD STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171578",
            "telephone_number": "702-268-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUENTES",
        "first_name": "LEILANI",
        "middle_name": "RENA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PA132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEILANI",
            "last_name": "CHAVEZ",
            "middle_name": "RENA",
            "prefix": "MRS.",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 26, 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.