NPIMap

Organization Active NPI

Serenity Mind Spa PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Henderson, NV
National Provider Identifier
1669352886
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SERENITY MIND SPA PLLC
Practice address
30 Via Mantova Unit 302
Henderson, NV 89011-2267
Phone
(702) 487-3650
NPI assigned
Sep 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
La Toya Wilkerson, CPC-INPI 1134531650
Title
Qualified Mental Health Professiona
Phone
(702) 487-3650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

30 Via Mantova Unit 302
Henderson, NV 89011-2267

Mailing address

30 Via Mantova Unit 302
Henderson, NV 89011-2267
Phone (702) 487-3650

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1669352886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 VIA MANTOVA UNIT 302",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112267",
            "telephone_number": "702-487-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 VIA MANTOVA UNIT 302",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890112267",
            "telephone_number": "702-487-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY MIND SPA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-07",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "LA TOYA",
        "authorized_official_title_or_position": "QUALIFIED MENTAL HEALTH PROFESSIONA",
        "authorized_official_telephone_number": "702-487-3650",
        "authorized_official_credential": "CPC-I"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.