Active NPI
Raven Fogg
- Mental Health Counselor
- Las Vegas, NV
National Provider Identifier
1700287455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 10620 W Alexander Rd
124
Las Vegas, NV 89129-3526 - Phone
- (702) 331-3818
- NPI assigned
- Sep 12, 2014
- Last updated
- Sep 12, 2014
- Sex
- Female
- Sole proprietor
- No
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 | NU | Primary |
Addresses
Primary practice location
10620 W Alexander Rd
124
Las Vegas, NV 89129-3526
Mailing address
10620 W Alexander Rd
124
Las Vegas, NV 89129-3526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1700287455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10620 W ALEXANDER RD",
"address_2": "124",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891293526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10620 W ALEXANDER RD",
"address_2": "124",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891293526",
"telephone_number": "702-331-3818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGG",
"first_name": "RAVEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-12",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"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 Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.