American Grace Wellness Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

AMERICAN GRACE WELLNESS CENTER LLC

Practice address

3925 North Martin Luther King Blvd
Suite #212
North Las Vegas, NV 89032-7673

Phone

(702) 444-2335

Fax

(702) 992-3505

NPI assigned

Nov 14, 2022

Organization subpart

No

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

Authorized official

Name

Jacqueline B Glasper-Sattwhite, MSWNPI 1285910075

Title

Ceo

Phone

(702) 444-0235

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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

• Jacqueline Glasper-Sattwhite, BS,MBA,LCSW

  • Clinical Social Worker
  • North Las Vegas, NV
  • NPI 1285910075
  NPD Authorized official

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1760190136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 NORTH MARTIN LUTHER KING BLVD",
            "address_2": "SUITE #212",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327673",
            "telephone_number": "702-444-2335",
            "fax_number": "702-992-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 NORTH MARTIN LUTHER KING BLVD",
            "address_2": "SUITE #212",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327673",
            "telephone_number": "702-444-2335",
            "fax_number": "702-992-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN GRACE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "GLASPER-SATTWHITE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-444-0235",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA SOCIAL WORK BOARD",
            "identifier": "9028-C",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Behavioralhealth@amgracewellness.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3925 North Martin Luther King Blvd",
            "address_2": "Suite #212",
            "city": "North Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890327673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in North Las Vegas, NV
• Providers in North 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 Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.