Bethsabe Surya, CPC INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CI764 Issued in NV

Practice address

3808 Vincelli Ave
North Las Vegas, NV 89031-4811

Phone

(702) 581-7130

NPI assigned

Nov 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1821699000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 VINCELLI AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890314811",
            "telephone_number": "702-581-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 VINCELLI AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890314811",
            "telephone_number": "702-581-7130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10655 Park Run Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891444590",
            "country_code": "US",
            "telephone_number": "702-581-7130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURYA",
        "first_name": "BETHSABE",
        "credential": "CPC INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CI764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Mental Health Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.