Centennial Psychological Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6050-C Issued in NV

Legal business name

CENTENNIAL PSYCHOLOGICAL SERVICES

Practice address

7495 W Azure Dr
Ste 205
Las Vegas, NV 89130-4416

Phone

(702) 608-0404

NPI assigned

Mar 12, 2013

Organization subpart

No

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

Authorized official

Name

Nicole Pucci, L.C.S.W.

Title

Clinical Director

Phone

(702) 278-8911

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1629319918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7495 W AZURE DR",
            "address_2": "STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304416",
            "telephone_number": "702-608-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7495 W AZURE DR",
            "address_2": "STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891304416",
            "telephone_number": "702-608-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "PUCCI",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "702-278-8911",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "6050-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maria Yemi Centeno

• Clinical Social Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.