Organization Active NPI

Symphony Mind LLC

  • Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1669184412
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SYMPHONY MIND LLC
Practice address
2621 W Charleston Blvd
Las Vegas, NV 89102-2121
Phone
(702) 559-7801
NPI assigned
Dec 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Authorized official

Name
Joel Albert
Title
Manager
Phone
(725) 301-1182

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

2621 W Charleston Blvd
Las Vegas, NV 89102-2121

Mailing address

2619 W Charleston Blvd Ste D
Las Vegas, NV 89102-2121
Phone (725) 301-1182

Other identifiers 1

IdentifierTypeStateIssuer
2916MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240124000968 NV Part B Supplier - Clinic/Group Practice 3375996564 Receives reassigned benefits from 7 practitioners
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2326303Symphony Mind LLC2621 W Charleston Blvd, Las Vegas, NV 89102Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory

Locations

2621 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 431-2232

2621 W Charleston Blvd
Ste D
Las Vegas, NV 89102
Phone (615) 578-4065

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739664000000",
    "number": "1669184412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 W CHARLESTON BLVD STE D",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022121",
            "telephone_number": "725-301-1182",
            "fax_number": "702-441-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022121",
            "telephone_number": "702-559-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYMPHONY MIND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-22",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A",
        "authorized_official_last_name": "ALBERT",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "725-301-1182"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2916",
            "state": "NV"
        }
    ],
    "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 Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.