Executive Therapy Solutions

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EXECUTIVE THERAPY SOLUTIONS

Practice address

6887A W. Charleston Blvd.
Las Vegas, NV 89117

Phone

(702) 635-6800

Fax

(702) 869-8844

NPI assigned

Jan 24, 2020

Organization subpart

No

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

Authorized official

Name

Sandra Raichart, LCSWNPI 1093019028

Title

Clinical Social Worker/ Owner

Phone

(702) 635-6800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Raichart, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1093019028
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1740810092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 REGATTA DRIVE",
            "address_2": "SUITE 211",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89128",
            "telephone_number": "702-635-6800",
            "fax_number": "702-869-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6887A W. CHARLESTON BLVD.",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "702-635-6800",
            "fax_number": "702-869-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE THERAPY SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-24",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "RAICHART",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER/ OWNER",
        "authorized_official_telephone_number": "702-635-6800",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Exclusive Home Healthcare
• Exdous Family & Guidance Coalition LLC
• Executive Fitness Inc
• Executive Fitness Inc
• Executive Las Vegas
• Exellabs
• Tim D Exline
• Exodus Family & Guidance Coalition, LLC
• Exodus Family Guidance and Wellness, PLLC
• Haley Exon

• Clinical Social Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.