Individual provider Active NPI

Angella A Earle, LMFTI

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1639442064
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M10554 Issued in NV
Practice address
4160 S Pecos Rd Ste 21
Las Vegas, NV 89121-5025
Phone
(702) 665-4767
Fax
(702) 665-4763
NPI assigned
Feb 15, 2012
Last updated
Sep 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X M10554 NV Primary

Addresses

Primary practice location

4160 S Pecos Rd Ste 21
Las Vegas, NV 89121-5025

Mailing address

6679 Conquistador St
Las Vegas, NV 89149-1324
Phone (702) 409-6448

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
M10554NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Personal Care Services LLC Current Accepting new patients
Courageous Counseling LLC Current Accepting new patients

Locations

4160 S Pecos Rd
Ste 21
Las Vegas, NV 89121
Phone (702) 409-4668

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": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1639442064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6679 CONQUISTADOR ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891491324",
            "telephone_number": "702-409-6448",
            "fax_number": "702-665-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 S PECOS RD STE 21",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215025",
            "telephone_number": "702-665-4767",
            "fax_number": "702-665-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLE",
        "first_name": "ANGELLA",
        "middle_name": "A",
        "credential": "LMFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "M10554",
            "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 Sep 10, 2018; 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.