Phoenix Aerie

Individual provider Active NPI Counselor · Las Vegas, NV

NPI 1700214467 · NPPES record last updated Aug 21, 2026

Key facts

NPI
1700214467
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
9402 W Lake Mead Blvd Ste 102
Las Vegas, NV 89134-8312
Phone
(702) 438-7800
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Yes

Addresses

Primary practice location

9402 W Lake Mead Blvd Ste 102
Las Vegas, NV 89134-8312

Mailing address

9402 W Lake Mead Blvd Ste 102
Las Vegas, NV 89134-8312

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Counselor in Nevada

Sources for this page

Verify at the official NPI Registry.