Individual provider Active NPI

Kana Aoki Nootenboom, MFT

  • Marriage & Family Therapist
  • Henderson, NV
National Provider Identifier
1801320940
Registry record updated Apr 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
01435 Issued in NV
Practice address
2637 W Horizon Ridge Pkwy
Suite 130
Henderson, NV 89052-4834
Phone
(702) 530-1255
NPI assigned
Apr 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 01435 NV Primary

Addresses

Primary practice location

2637 W Horizon Ridge Pkwy
Suite 130
Henderson, NV 89052-4834

Mailing address

1476 Macdonald Ranch Dr
Henderson, NV 89012-7247
Phone (702) 530-1255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01435NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Light Marriage & Family Therapist Current Accepting new patients
Healing With Grace, LLC Marriage & Family Therapist Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492214400000",
    "number": "1801320940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1476 MACDONALD RANCH DR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890127247",
            "telephone_number": "702-530-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524834",
            "telephone_number": "702-530-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOOTENBOOM",
        "first_name": "KANA",
        "middle_name": "AOKI",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-15",
        "last_updated": "2017-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2017; 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.