Individual provider Active NPI

Wanda T White, CPC

  • Counselor
  • Las Vegas, NV
National Provider Identifier
1750629945
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CP5441 Issued in NV
Practice address
10501 W Gowan Rd Ste 130
Las Vegas, NV 89129-6602
Phone
(702) 530-2612
Fax
(702) 725-2526
NPI assigned
Jan 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CP5441 NV Primary

Addresses

Primary practice location

10501 W Gowan Rd Ste 130
Las Vegas, NV 89129-6602

Mailing address

10501 W Gowan Rd Ste 130
Las Vegas, NV 89129-6602
Phone (702) 530-2612

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
I20240215004069 NV Practitioner - Mental Health Counselor 9739523986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6955 N Durango Dr
Unit 1004
Las Vegas, NV 89149-4412
Phone (702) 530-2612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP5441NVMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arranged Thought LLC CurrentSince Dec 1, 2024 Accepting new patients
Embrace the Journey LLC CurrentSince Jan 1, 2024 Accepting new patients
Rethink Therapy, LLC PastSince Aug 1, 2020 Accepting new patients

Locations

6955 N Durango Dr
Unit 1004
Las Vegas, NV 89149
Phone (702) 530-2612

10501 W Gowan Rd
Ste 130
Las Vegas, NV 89129
Phone (702) 530-2612

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": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1750629945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 W GOWAN RD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296602",
            "telephone_number": "702-530-2612",
            "fax_number": "702-725-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 W GOWAN RD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296602",
            "telephone_number": "702-530-2612",
            "fax_number": "702-725-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "WANDA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "CPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NV",
            "license": "CP5441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.