Individual provider Active NPI

Kristina Andaya, LCPC

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1467087759
Registry record updated Feb 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CP5541 Issued in NV
Practice address
8879 W Flamingo Rd Ste 101
Las Vegas, NV 89147-8732
Phone
(702) 626-1072
NPI assigned
Mar 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CP5541 NV Primary

Addresses

Primary practice location

8879 W Flamingo Rd Ste 101
Las Vegas, NV 89147-8732

Mailing address

4340 W Arby Ave
Las Vegas, NV 89118-5108
Phone (702) 626-1072

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

State licenses

LicenseStateTypeSpecialty
CP5541NVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Awake Wellness Center LLC CurrentSince May 25, 2021 Accepting new patients

Locations

8879 W Flamingo Rd
Ste 101
Las Vegas, NV 89147
Phone (702) 595-6462

Organizations & group practices 1

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": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1467087759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 W ARBY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891185108",
            "telephone_number": "702-626-1072",
            "fax_number": "800-380-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8879 W FLAMINGO RD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478732",
            "telephone_number": "702-626-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDAYA",
        "first_name": "KRISTINA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP5541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 24, 2024; 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.