Mountain Vista Wellness Group LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MOUNTAIN VISTA WELLNESS GROUP LLC

Practice address

1953 Bayhurst Ave
North Las Vegas, NV 89031-0751

Phone

(708) 537-6511

NPI assigned

Jun 21, 2019

Organization subpart

No

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

Authorized official

Name

Kelvin Anderson

Title

Owner

Phone

(708) 537-6511

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1407417348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 BAYHURST AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310751",
            "telephone_number": "708-537-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 BAYHURST AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310751",
            "telephone_number": "708-537-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VISTA WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KELVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-537-6511"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Mental Health Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.