Individual provider Active NPI

Pamela Shawn-Stivers Gomez, M.S. LMFT

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1699213926
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
3275 S Jones Blvd Ste 105
Las Vegas, NV 89146-6768
Phone
(702) 800-0590
NPI assigned
Feb 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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 Primary

Addresses

Primary practice location

3275 S Jones Blvd Ste 105
Las Vegas, NV 89146-6768

Mailing address

3275 S Jones Blvd Ste 105
Las Vegas, NV 89146-6768
Phone (702) 278-9350

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
I20241105000909 NV Practitioner - Marriage and Family Therapist 7416481007 Practice locations: Las Vegas, NV

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2698NVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Healing Center PastSince May 1, 2023 Accepting new patients

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": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1699213926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 S JONES BLVD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466768",
            "telephone_number": "702-278-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 S JONES BLVD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891466768",
            "telephone_number": "702-800-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "PAMELA",
        "middle_name": "SHAWN-STIVERS",
        "name_prefix": "Mrs.",
        "credential": "M.S. LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.