Individual provider Active NPI

Carol Kohn-Mannis, LCSW

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1649457680
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4252-C Issued in NV
Practice address
10809 Garden Mist Dr
# 2028
Las Vegas, NV 89135-2873
Phone
(702) 326-1702
Fax
(702) 240-7333
NPI assigned
Jan 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4252-C NV Primary

Addresses

Primary practice location

10809 Garden Mist Dr
# 2028
Las Vegas, NV 89135-2873

Mailing address

10809 Garden Mist Dr.
# 2028
Las Vegas, NV 89135-2883
Phone (702) 326-1702

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
I20040512001272 NV Practitioner - Clinical Social Worker 8426048562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Nueva Vida Mental Health LLCGroup PAC ID 3678702701, 2 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4252-CNVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nueva Vida Mental Health LLC CurrentSince May 18, 2019 Accepting new patients
Balanced Mind Centers LLC PastSince Dec 23, 2017 Accepting new patients
Skills 4 Kids, LLC PastSince Aug 16, 2020 Accepting new patients
Catholic Charities of Diocese of Albany PastSince Jan 22, 2018 Accepting new patients
Catholic Charities of Saratoga, Warren and Washington Counties Past Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. PastSince May 18, 2019 Accepting new patients

Locations

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

Organizations & group practices 6

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": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1649457680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10809 GARDEN MIST DR.",
            "address_2": "# 2028",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891352883",
            "telephone_number": "702-326-1702",
            "fax_number": "702-240-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10809 GARDEN MIST DR",
            "address_2": "# 2028",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891352873",
            "telephone_number": "702-326-1702",
            "fax_number": "702-240-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHN-MANNIS",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "4252-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.