Active NPI
Marta A. T. Wilson, MFT, CPC, LCADC
- Marriage & Family Therapist
- Las Vegas, NV
National Provider Identifier
1740221993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 01035
- Practice address
- 6375 W Charleston Blvd
Ste. a-172
Las Vegas, NV 89146-1139 - Phone
- (702) 877-0684
- Fax
- (702) 877-0684
- NPI assigned
- Jun 9, 2006
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 01035 | NV | Primary |
Addresses
Primary practice location
6375 W Charleston Blvd
Ste. a-172
Las Vegas, NV 89146-1139
Mailing address
6375 W Charleston Blvd
Ste. a-100
Las Vegas, NV 89146-1139
Phone (702) 253-0818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100508688 | Medicaid | NV |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01035 | NV | MD | Marriage & Family Therapist |
Interoperability endpoints
- mwilson87292@direct.umcsn.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262131200000",
"number": "1740221993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6375 W CHARLESTON BLVD",
"address_2": "STE. A-100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891461139",
"telephone_number": "702-253-0818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6375 W CHARLESTON BLVD",
"address_2": "STE. A-172",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891461139",
"telephone_number": "702-877-0684",
"fax_number": "702-877-0684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MARTA",
"middle_name": "A. T.",
"credential": "MFT, CPC, LCADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-09",
"last_updated": "2009-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NV",
"license": "01035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100508688",
"state": "NV"
}
],
"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 Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.