Active NPI
Jeremy Joseph Urcioli
- Mental Health Counselor
- Las Vegas, NV
National Provider Identifier
1699386250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CI2951
- Practice address
- 4055 Spencer St
Las Vegas, NV 89119-9303 - Phone
- (702) 799-9710
- NPI assigned
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CI2951 | NV | Primary |
Addresses
Primary practice location
4055 Spencer St
Las Vegas, NV 89119-9303
Mailing address
503 Calypso Dr
Henderson, NV 89002-9618
Phone (170) 230-0839
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240117003569 | NV | Order and Referring Only - Mental Health Counselor | 2860844693 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CI2951 | NV | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597536000000",
"number": "1699386250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 CALYPSO DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890029618",
"telephone_number": "170-230-0839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 SPENCER ST",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891199303",
"telephone_number": "702-799-9710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URCIOLI",
"first_name": "JEREMY",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-16",
"last_updated": "2020-08-16",
"certification_date": "2020-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CI2951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.