Individual provider Active NPI

Miryam Godinez, MFT - 4153

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1609177740
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8100 Lanceleaf Ave
Las Vegas, NV 89131-8126
Phone
(702) 379-5421
NPI assigned
Nov 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

8100 Lanceleaf Ave
Las Vegas, NV 89131-8126

Mailing address

4760 S Pecos Rd Ste 200
Las Vegas, NV 89121-5828
Phone (702) 379-5421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251015004475 NV Practitioner - Marriage and Family Therapist 8820585508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Solutions LLCGroup PAC ID 9436469764, 3 clinicians

Practice addresses (Care Compare)

4250 E Bonanza Rd
Suite 17
Las Vegas, NV 89110-6105
Phone (702) 331-4277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4153NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Light of of Hope Counseling Bilingual Mental Health Current Accepting new patients
Therapeutic Solutions LLC Single Specialty CurrentSince Aug 2, 2025 Accepting new patients

Locations

4250 E Bonanza Rd
Ste 17
Las Vegas, NV 89110
Phone (702) 331-4277

4760 S Pecos Rd
Ste 200
Las Vegas, NV 89121
Phone (702) 219-2244

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": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1609177740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215828",
            "telephone_number": "702-379-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 LANCELEAF AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891318126",
            "telephone_number": "702-379-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODINEZ",
        "first_name": "MIRYAM",
        "name_prefix": "Mrs.",
        "credential": "MFT - 4153",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.