Yolanda Wibowo, CPC- I

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CP5802 Issued in NV

Practice address

2520 Saint Rose Pkwy
Henderson, NV 89074-7783

Phone

(702) 408-0480

NPI assigned

Oct 14, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1407519655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY STE 220E",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747789",
            "telephone_number": "702-408-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 SAINT ROSE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747783",
            "telephone_number": "702-408-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBOWO",
        "first_name": "YOLANDA",
        "credential": "CPC- I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP5802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Henderson, NV
• Providers in Henderson, 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 Apr 22, 2025; 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.