58 10 Behavioral Health Services PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

58 10 BEHAVIORAL HEALTH SERVICES PLLC

Practice address

1810 E Sahara Ave Ste 212 373
Las Vegas, NV 89104-3707

Phone

(702) 286-5386

Fax

(702) 566-4575

NPI assigned

Feb 19, 2020

Organization subpart

No

Name

Alvin Kenon, LCSWNPI 1275913030

Title

Owner

Phone

(702) 286-5386

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

• Alvin Kenon

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1275913030

  Clinical, NV

  Medicare reassignment NPD Authorized official
• Marcy Melendrez, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1528518800

  Clinical, NV

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in NV

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 19, 2020.

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1780217679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 E SAHARA AVE STE 212 373",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043707",
            "telephone_number": "702-286-5386",
            "fax_number": "702-566-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 E SAHARA AVE STE 212 373",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891043707",
            "telephone_number": "702-286-5386",
            "fax_number": "702-566-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "58 10 BEHAVIORAL HEALTH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "KENON",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-286-5386",
        "authorized_official_credential": "LCSW"
    },
    "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": "NPI",
            "identifier": "1275913030",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 4Eleven Management
• 4G Dental Partners
• 5 Star Disability Services LV LLC
• 5 Star Hospice and Palliative Care Inc
• 5 Star Medical Health Services LLC
• 6 Sitts PC
• 6Radiology
• 702 Caregivers, LLC
• 702 Caregivers, LLC
• 702 Caregivers, LLC

• All providers in Las Vegas, NV
• Clinical Social Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.