Jennifer Antonucci, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MI0733 Issued in NV

Practice address

3243 E Warm Springs Rd
Las Vegas, NV 89120-3185

Phone

(702) 434-7290

NPI assigned

Oct 15, 2014

Last updated

Jul 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Renewing Life Center

  • Marriage & Family Therapist
  • Las Vegas, NV
  • NPI 1699174839
  Medicare reassignment NPD
• Comprehensive Psychological Services LLC

  • Clinical Psychologist
  • Henderson, NV
  • NPI 1972795680
  NPD (past)

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1609270974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10994 LADYBURN CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891414358",
            "telephone_number": "702-235-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3243 E WARM SPRINGS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203185",
            "telephone_number": "702-434-7290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3960 E Patrick Ln Ste 204",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891204902",
            "country_code": "US",
            "telephone_number": "702-489-4117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTONUCCI",
        "first_name": "JENNIFER",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI0733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Mario Antonino, PT,OCS
• Antonio Cruz
• Antonio Serru Paez MD Professional Corporation (Caring Health Center)
• Leticia Antonio
• Tracy Antonio
• Leila Antonucci
• Olga Antonyan
• Ripsime Antonyan
• Antrice Hronek PSYD PLLC
• Antuna Medical PLLC

• Marriage & Family Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Marriage & Family Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.