Individual provider Active NPI

Cristiano Sebastian Mitchell

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1366220360
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12799C Issued in NV
Practice address
2980 S Rainbow Blvd # 200B
Las Vegas, NV 89146-6531
Phone
(702) 817-1663
NPI assigned
Sep 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12799C NV Primary

Addresses

Primary practice location

2980 S Rainbow Blvd # 200B
Las Vegas, NV 89146-6531

Mailing address

457 Via Stretto Ave
Henderson, NV 89011-0837
Phone (702) 817-1663

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
12799CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1366220360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 VIA STRETTO AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890110837",
            "telephone_number": "702-817-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 S RAINBOW BLVD # 200B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466531",
            "telephone_number": "702-817-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CRISTIANO",
        "middle_name": "SEBASTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-20",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "12799C",
            "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 May 20, 2026; 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.