Individual provider Active NPI

Amia P. Mulholland, LMFT-I

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1710128731
Registry record updated Jan 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MI0322 Issued in NV
Practice address
6871 W Charleston Blvd
Las Vegas, NV 89117-1600
Phone
(702) 332-3006
Fax
(702) 489-4049
NPI assigned
Mar 20, 2009
Last updated
Jan 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2018

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 MI0322 NV Primary

Addresses

Primary practice location

6871 W Charleston Blvd
Las Vegas, NV 89117-1600

Mailing address

6871 W Charleston Blvd
Las Vegas, NV 89117-1600
Phone (702) 332-3006

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
I20240126000106 NV Practitioner - Marriage and Family Therapist 8820303084 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI0322NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ebl Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

6871 W Charleston Blvd
Las Vegas, NV 89117
Phone (702) 489-2117

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516406400000",
    "number": "1710128731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6871 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171600",
            "telephone_number": "702-332-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6871 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171600",
            "telephone_number": "702-332-3006",
            "fax_number": "702-489-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "AMIA",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "LMFT-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-20",
        "last_updated": "2018-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI0322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.