Individual provider Active NPI

Nadia Roman-Leiva

  • Psychoanalyst
  • Las Vegas, NV
National Provider Identifier
1568080059
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
IC-1620 Issued in NV
Practice address
4170 S Decatur Blvd Ste C1
Las Vegas, NV 89103-5863
Phone
(702) 659-8827
NPI assigned
Jul 10, 2020
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X IC-1620 NV Primary

Addresses

Primary practice location

4170 S Decatur Blvd Ste C1
Las Vegas, NV 89103-5863

Mailing address

4170 S Decatur Blvd Ste C1
Las Vegas, NV 89103-5863
Phone (702) 659-8827

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
IC-1620NVMDPsychoanalyst

Practice roles

OrganizationSpecialtyStatusNew patients
Nueva Vida Mental Health LLC CurrentSince Sep 27, 2020 Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. PastSince Sep 27, 2020 Accepting new patients

Locations

4170 S Decatur Blvd
Ste C1
Las Vegas, NV 89103
Phone (702) 659-8827

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1568080059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4170 S DECATUR BLVD STE C1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035863",
            "telephone_number": "702-659-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4170 S DECATUR BLVD STE C1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035863",
            "telephone_number": "702-659-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN-LEIVA",
        "first_name": "NADIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NV",
            "license": "IC-1620",
            "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 Nov 6, 2020; 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.