Individual provider Active NPI

Breonda Javonne Dixon, LCPC, LCADC

  • Counselor
  • Las Vegas, NV
National Provider Identifier
1396177697
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CP5702 Issued in NV
Practice address
5510 S Fort Apache Rd Ste 270
Las Vegas, NV 89148-7700
Phone
(702) 283-1437
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CP5702 NV Primary

Addresses

Primary practice location

5510 S Fort Apache Rd Ste 270
Las Vegas, NV 89148-7700

Mailing address

PO Box 335122
North Las Vegas, NV 89033-5122
Phone (702) 283-1437

Other practice location 1

3601 W Sahara Ave Ste 210
Las Vegas, NV 89102-5821
Phone (702) 268-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251003002973 NV Practitioner - Mental Health Counselor 4981100385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11500 S Eastern Ave
Suite 150
Henderson, NV 89052-5576

4817 Morning Falls Ave
Las Vegas, NV 89131-3648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Re-Start Center LLC CurrentSince Oct 27, 2024 Accepting new patients
Victorious Healing LLC CurrentSince Nov 9, 2025 Accepting new patients
Urban Healthy Minds, LLC CurrentSince Jul 7, 2025 Accepting new patients

Locations

11500 S Eastern Ave
Ste 150
Henderson, NV 89052
Phone (702) 552-7138

3601 W Sahara Ave
Ste 210
Las Vegas, NV 89102
Phone (702) 268-2001

Organizations & group practices 3

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1396177697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 335122",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890335122",
            "telephone_number": "702-283-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 S FORT APACHE RD STE 270",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487700",
            "telephone_number": "702-283-1437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W Sahara Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891025821",
            "country_code": "US",
            "telephone_number": "702-268-2001",
            "fax_number": "702-268-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "BREONDA",
        "middle_name": "JAVONNE",
        "credential": "LCPC, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NV",
            "license": "CP5702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.