Individual provider Active NPI

Melissa F Kalodner, PSY. D.

  • Clinical Psychologist
  • Henderson, NV
National Provider Identifier
1730113168
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0411 Issued in NV
Practice address
10120 S Eastern Ave Ste 225
Henderson, NV 89052-3951
Phone
(702) 492-1232
Fax
(480) 462-2302
NPI assigned
Jul 10, 2006
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0411 NV Primary

Addresses

Primary practice location

10120 S Eastern Ave Ste 225
Henderson, NV 89052-3951

Mailing address

1701 Wellness Way Ste 200
Las Vegas, NV 89106-4146
Phone (702) 310-9110

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
I20191203002723 NV Practitioner - Clinical Psychologist 8022441112 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0411NVMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Counseling LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

2360 W Horizon Ridge Pkwy
Ste 120
Henderson, NV 89052
Phone (702) 518-7629

Organizations & group practices 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1730113168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WELLNESS WAY STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064146",
            "telephone_number": "702-310-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 S EASTERN AVE STE 225",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523951",
            "telephone_number": "702-492-1232",
            "fax_number": "480-462-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALODNER",
        "first_name": "MELISSA",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "0411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.