Chanell MJ Allen, QMHP
Individual provider Active NPI Counselor · Las Vegas, NV
NPI 1558098962 · NPPES record last updated Feb 7, 2024
Key facts
- NPI
- 1558098962
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 23-QMHA-I-004113
- Practice address
- 2400 N Tenaya Way
Las Vegas, NV 89128-0420 - Phone
- (702) 379-5927
- NPI assigned
- Aug 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21-QMHA-R1929 | OR | MD | Rehabilitation Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 21-QMHA-R1929 | OR | |
| Counselor | 101Y00000X | 23-QMHA-I-004113 | Yes |
Addresses
Primary practice location
2400 N Tenaya Way
Las Vegas, NV 89128-0420
Mailing address
4780 W Ann Rd Ste 375
North Las Vegas, NV 89031-3470
Phone (702) 550-9323
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23-QMHA-I-004113 | Other | MHACBO |
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.