Vivian Leticia Stovall, PSY.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0844 Issued in NV

Practice address

1820 E Warm Springs Rd Ste 115
Las Vegas, NV 89119-4680

Phone

(702) 546-9600

Fax

(702) 829-8065

NPI assigned

Dec 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Psychology Institute of Las Vegas PLLCGroup PAC ID 9537599071, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• The Psychology Institute of Las Vegas PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Las Vegas, NV
  • NPI 1285269100
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1801330626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 FARM RD STE 180",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891318171",
            "telephone_number": "702-546-9600",
            "fax_number": "702-829-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E WARM SPRINGS RD STE 115",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194680",
            "telephone_number": "702-546-9600",
            "fax_number": "702-829-8065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1880 Star Batt Dr",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "483093709",
            "country_code": "US",
            "telephone_number": "832-372-5616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "VIVIAN",
        "middle_name": "LETICIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016144",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharijae Stout
• Zenie Stout
• Aileen Carmona Stovall
• Jeffrey M Stovall
• Stacey Stovall
• Ruslana Stovner
• Carmen Stowe
• Laura Stowe
• Emanza Stowers
• Michael Stowers

• Clinical Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.