NPIMap

Organization Active NPI

Restoration and Recovery, LLC

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1467847657
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01306 Issued in NV
Legal business name
RESTORATION AND RECOVERY, LLC
Practice address
7495 W Azure Dr Ste 246
Las Vegas, NV 89130-4436
Phone
(702) 302-4288
Fax
(702) 790-2570
NPI assigned
Apr 3, 2015
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Marivelle Nunez-Rucker, LMFT, CADC-I
Title
Owner
Phone
(702) 750-9387

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 01316-INTERN NV
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 01306 NV Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 6766 NV

Addresses

Primary practice location

7495 W Azure Dr Ste 246
Las Vegas, NV 89130-4436

Mailing address

6120 Skokie Court
Las Vegas, NV 89130
Phone (702) 374-8500

Other practice location 1

7495 W Azure Dr Ste 246
Las Vegas, NV 89130-4436
Phone (702) 302-4288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171031002588 NV Part B Supplier - Clinic/Group Practice 9537435854 Receives reassigned benefits from 3 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Tax ID family
Restoration and Recovery LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1467847657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 SKOKIE COURT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89130",
            "telephone_number": "702-374-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7495 W AZURE DR STE 246",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304436",
            "telephone_number": "702-302-4288",
            "fax_number": "702-790-2570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7495 W Azure Dr Ste 246",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891304436",
            "country_code": "US",
            "telephone_number": "702-302-4288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESTORATION AND RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "NUNEZ-RUCKER",
        "authorized_official_first_name": "MARIVELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-750-9387",
        "authorized_official_credential": "LMFT, CADC-I"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "01316-INTERN",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "01306",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "6766",
            "primary": false
        }
    ],
    "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 Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.