Individual provider Active NPI

Mary Anne Murray, M.S., M.F.T.

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1679796643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
868 Issued in NV
Practice address
1050 S Rainbow Blvd
Las Vegas, NV 89145-6231
Phone
(702) 258-5855
Fax
(702) 258-9767
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 868 NV Primary

Addresses

Primary practice location

1050 S Rainbow Blvd
Las Vegas, NV 89145-6231

Mailing address

1050 S Rainbow Blvd
Family and Child Treatment
Las Vegas, NV 89145-6231
Phone (702) 258-5855

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
I20250114003302 NV Practitioner - Marriage and Family Therapist 1153859426 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
868NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Behavioral Services LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

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

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679796643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 S RAINBOW BLVD",
            "address_2": "FAMILY AND CHILD TREATMENT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456231",
            "telephone_number": "702-258-5855",
            "fax_number": "702-258-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891456231",
            "telephone_number": "702-258-5855",
            "fax_number": "702-258-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "M.S., M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.