Individual provider Active NPI

Vicki Diaz Debeauvernet, MS, LADC, LMFT

  • Marriage & Family Therapist
  • Reno, NV
National Provider Identifier
1447573142
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
01332 Issued in NV
Practice address
255 N Sierra St Unit 1115
Reno, NV 89501-1368
Phone
(415) 424-4266
Fax
(415) 520-6633
NPI assigned
Mar 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1503-L NV
Marriage & Family Therapist 106H00000X 01332 NV Primary

Addresses

Primary practice location

255 N Sierra St Unit 1115
Reno, NV 89501-1368

Mailing address

8300 Esters Blvd Ste 900
Irving, TX 75063-2233
Phone (415) 424-4266

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1503-LNVMDAddiction (Substance Use Disorder) Counselor
01332NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Telehealth Services USA Marriage & Family Therapist PastSince Sep 5, 2023 Accepting new patients
Aa Psychology PLLC Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 2

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": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1447573142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 ESTERS BLVD STE 900",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632233",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N SIERRA ST UNIT 1115",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895011368",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBEAUVERNET",
        "first_name": "VICKI",
        "middle_name": "DIAZ",
        "name_prefix": "Ms.",
        "credential": "MS, LADC, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "1503-L",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.