NPIMap

Organization Active NPI

Phases of Life Consulting

Doing business as Impact Behavioral Services

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1427325646
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PHASES OF LIFE CONSULTING
Doing business as
Impact Behavioral Services
Practice address
8301 Boseck Dr # 16229
Las Vegas, NV 89145-4554
Phone
(702) 858-7086
Fax
(702) 966-3839
NPI assigned
Nov 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Carolyn S Pridgeon
Title
Ceo
Phone
(702) 858-7086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NV Primary

Addresses

Primary practice location

8301 Boseck Dr # 16229
Las Vegas, NV 89145-4554

Mailing address

8301 Boseck Dr # 16229
Las Vegas, NV 89145-4554
Phone (702) 858-7086

Other names 1

  • Impact Behavioral Services Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1427325646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 BOSECK DR # 16229",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454554",
            "telephone_number": "702-858-7086",
            "fax_number": "702-966-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 BOSECK DR # 16229",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454554",
            "telephone_number": "702-858-7086",
            "fax_number": "702-966-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHASES OF LIFE CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "PRIDGEON",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-858-7086"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact Behavioral Services",
            "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 Nov 17, 2011; 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.