Individual provider Active NPI

Sherita Loveon Childress, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1811285331
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6817-C Issued in NV
Practice address
400 Shadow LN Ste 104
Las Vegas, NV 89106-4355
Phone
(702) 731-0909
Fax
(702) 826-4757
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Clinical Social Worker 1041C0700X 6817-C NV Primary

Addresses

Primary practice location

400 Shadow LN Ste 104
Las Vegas, NV 89106-4355

Mailing address

8936 Spanish Ridge Ave Ste 104105
Las Vegas, NV 89148-1354
Phone (702) 731-0909

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200107001077 NV Practitioner - Clinical Social Worker 5496189011 Reassigns benefits to 1 organization
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6817-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nevada Pediatric Therapy LLC Current Accepting new patients
Cognitive Care Solutions Group Inc CurrentSince Oct 20, 2019 Accepting new patients
Firstmed Health and Wellness Center Inc PastSince Jan 15, 2023 Accepting new patients

Locations

3943 Irvine Blvd
Irvine, CA 92602
Phone (714) 922-0120

2320 Ione Rd
Las Vegas, NV 89183
Phone (725) 200-3400

3652 N Rancho Dr
Ste 102
Las Vegas, NV 89130
Phone (702) 334-6162

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDEACA

Organizations & group practices 3

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": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1811285331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8936 SPANISH RIDGE AVE STE 104105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481354",
            "telephone_number": "702-731-0909",
            "fax_number": "702-998-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SHADOW LN STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064355",
            "telephone_number": "702-731-0909",
            "fax_number": "702-826-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "SHERITA",
        "middle_name": "LOVEON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "6817-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.