Individual provider Active NPI

Jana Mitchell-Momoh

  • Counselor
  • Henderson, NV
National Provider Identifier
1669924908
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1050 Whitney Ranch Dr
Henderson, NV 89014-2540
Phone
(612) 743-7385
NPI assigned
Nov 3, 2016
Reactivated
Sep 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Rehabilitation Practitioner 225400000X
Personal Care Attendant 3747P1801X
Counselor 101Y00000X Primary

Addresses

Primary practice location

1050 Whitney Ranch Dr
Henderson, NV 89014-2540

Mailing address

1050 Whitney Ranch Dr Apt 1626
Henderson, NV 89014-2546
Phone (127) 437-3856

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bell Medical Services Inc. Current Accepting new patients
Skills 4 Kids, LLC Counselor Past Accepting new patients

Locations

6901 78th Ave N
Ste 104
Brooklyn Park, MN 55445
Phone (763) 208-0975

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1669924908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 WHITNEY RANCH DR APT 1626",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142546",
            "telephone_number": "127-437-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 WHITNEY RANCH DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142540",
            "telephone_number": "612-743-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL-MOMOH",
        "first_name": "JANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "deactivation_date": "2017-11-15",
        "reactivation_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "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 4, 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.