Individual provider Active NPI

Rory Reid, PH.D., LCSW

  • Clinical Social Worker
  • Henderson, NV
National Provider Identifier
1679023196
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7314-C Issued in NV
Practice address
2218 Summerwind Cir
Henderson, NV 89052-2321
Phone
(310) 890-0599
NPI assigned
Oct 7, 2016
Last updated
Jul 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X 7314-C NV Primary

Addresses

Primary practice location

2218 Summerwind Cir
Henderson, NV 89052-2321

Mailing address

2218 Summerwind Cir
Henderson, NV 89052-2321
Phone (310) 890-0599

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
I20210415000905 NV Practitioner - Clinical Social Worker 9638587413 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Counseling and Consulting LLC Clinical CurrentSince Jul 27, 2020 Accepting new patients
Novum Behavioral Health Systems, LLC CurrentSince Apr 20, 2022 Accepting new patients
Fundamental Behavioral Services LLC CurrentSince Apr 2, 2021 Accepting new patients

Locations

2600 N 44th St
Phoenix, AZ 85008
Phone (602) 610-9594

2921 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 338-8373

3035 S Maryland Pkwy
Ste 110
Las Vegas, NV 89109
Phone (702) 751-2547

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1679023196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 SUMMERWIND CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522321",
            "telephone_number": "310-890-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 SUMMERWIND CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522321",
            "telephone_number": "310-890-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "RORY",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-07",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "7314-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.