NPIMap

Organization Active NPI

Beautiful Mind of Las Vegas LLC

Doing business as Beautiful Mind

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1356940639
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BEAUTIFUL MIND OF LAS VEGAS LLC
Doing business as
Beautiful Mind
Practice address
3841 W Charleston Blvd Ste 202
Las Vegas, NV 89102-1858
Phone
(702) 808-0011
NPI assigned
Oct 19, 2020
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Jessica Tinte Erfe, RN
Title
Manager Member
Phone
(702) 704-9611

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X NU Primary
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

3841 W Charleston Blvd Ste 202
Las Vegas, NV 89102-1858

Mailing address

3841 W Charleston Blvd Ste 202
Las Vegas, NV 89102-1858
Phone (702) 808-0011

Other names 1

  • Beautiful Mind Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240507004408 NV Part B Supplier - Clinic/Group Practice 9032550199 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1356940639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 W CHARLESTON BLVD STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021858",
            "telephone_number": "702-808-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 W CHARLESTON BLVD STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021858",
            "telephone_number": "702-808-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL MIND OF LAS VEGAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "ERFE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "TINTE",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "702-704-9611",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beautiful Mind",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beautiful Mind",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.