NPIMap

Organization Active NPI

My Restored Self Counseling Services LLC

  • Counselor
  • Las Vegas, NV
National Provider Identifier
1770090474
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
443-LC Issued in NV
Legal business name
MY RESTORED SELF COUNSELING SERVICES LLC
Practice address
9509 Walking Spirit CT
Las Vegas, NV 89129-7899
Phone
(702) 741-7183
NPI assigned
Jan 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Authorized official

Name
Dawn M Hill, LCPC, LCADCNPI 1194068874
Title
Owner
Phone
(702) 741-7183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 443-LC NV Primary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

9509 Walking Spirit CT
Las Vegas, NV 89129-7899

Mailing address

9509 Walking Spirit CT
Las Vegas, NV 89129-7899
Phone (702) 741-7183

Other identifiers 1

IdentifierTypeStateIssuer
1194068874MedicaidNV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1770090474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9509 WALKING SPIRIT CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297899",
            "telephone_number": "702-741-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9509 WALKING SPIRIT CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297899",
            "telephone_number": "702-741-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY RESTORED SELF COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-741-7183",
        "authorized_official_credential": "LCPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "NV",
            "license": "443-LC",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194068874",
            "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 Nov 5, 2019; 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.