Individual provider Active NPI

Alicia Antoinette Runyan, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1821641242
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9752-C Issued in NV
Practice address
2400 N Tenaya Way Ste 301
Las Vegas, NV 89128-0645
Phone
(725) 222-0263
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9752-C NV Primary

Addresses

Primary practice location

2400 N Tenaya Way Ste 301
Las Vegas, NV 89128-0645

Mailing address

2400 N Tenaya Way Ste 301
Las Vegas, NV 89128-0645
Phone (725) 222-0263

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
I20250331000315 NV Practitioner - Clinical Social Worker 6103348099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2400 N Tenaya Way
Suite 301
Las Vegas, NV 89128-0645
Phone (725) 222-0263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Peace Therapy LLC Clinical CurrentSince Feb 9, 2025 Accepting new patients

Locations

2400 N Tenaya Way
Ste 309
Las Vegas, NV 89128
Phone (725) 222-0263

2400 N Tenaya Way
Ste 301
Las Vegas, NV 89128
Phone (725) 222-0263

Organizations & group practices 1

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1821641242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N TENAYA WAY STE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280645",
            "telephone_number": "725-222-0263",
            "fax_number": "725-262-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N TENAYA WAY STE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280645",
            "telephone_number": "725-222-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYAN",
        "first_name": "ALICIA",
        "middle_name": "ANTOINETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9752-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.