Individual provider Active NPI

Rodney Johnson, CADC, LCPC

  • Professional Counselor
  • Las Vegas, NV
National Provider Identifier
1649544735
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CP5226-R Issued in NV
Practice address
2780 S Jones Blvd Ste 115D
Las Vegas, NV 89146-5625
Phone
(702) 935-0025
Fax
(702) 935-0008
NPI assigned
Mar 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00714-C NV
Professional Counselor 101YP2500X CI636 NV
Professional Counselor 101YP2500X CP5226-R NV Primary

Addresses

Primary practice location

2780 S Jones Blvd Ste 115D
Las Vegas, NV 89146-5625

Mailing address

5382 Homeria St
Las Vegas, NV 89113-1839
Phone (702) 956-2009

Other practice location 1

5382 Homeria St
Las Vegas, NV 89113-1839
Phone (702) 328-8151

Other practice location 2

2920 N Green Valley Pkwy Ste 312
Henderson, NV 89014-0412
Phone (702) 935-0025

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
00714-CNVMDAddiction (Substance Use Disorder) Counselor
CI636NVMDProfessional Counselor
CP5226-RNVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
True Life Coaching LLC Professional CurrentSince Sep 5, 2023 Accepting new patients

Locations

2920 N Green Valley Pkwy
Ste 312
Henderson, NV 89014
Phone (702) 253-1173

2780 S Jones Blvd
Ste 115D
Las Vegas, NV 89146
Phone (702) 935-0025

Organizations & group practices 1

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": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1649544735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5382 HOMERIA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131839",
            "telephone_number": "702-956-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 S JONES BLVD STE 115D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465625",
            "telephone_number": "702-935-0025",
            "fax_number": "702-935-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5382 Homeria St",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891131839",
            "country_code": "US",
            "telephone_number": "702-328-8151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2920 N Green Valley Pkwy Ste 312",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890140412",
            "country_code": "US",
            "telephone_number": "702-935-0025",
            "fax_number": "702-935-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RODNEY",
        "credential": "CADC,  LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-07",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "00714-C",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI636",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CP5226-R",
            "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 Aug 29, 2023; 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.