Individual provider Active NPI

Garrett Engle, MFT-INTERN

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1821734971
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MI4090 Issued in NV
Practice address
10655 Park Run Dr
Las Vegas, NV 89144-4589
Phone
(702) 301-8202
NPI assigned
May 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2022

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 MI4090 NV Primary

Addresses

Primary practice location

10655 Park Run Dr
Las Vegas, NV 89144-4589

Mailing address

10655 Park Run Dr
Las Vegas, NV 89144-4589
Phone (702) 301-8202

Other identifiers 1

IdentifierTypeStateIssuer
1704053355OtherNVNEVADA DRIVERS LICENSE

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
MI4090NVMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1821734971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10655 PARK RUN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891444589",
            "telephone_number": "702-301-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10655 PARK RUN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891444589",
            "telephone_number": "702-301-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLE",
        "first_name": "GARRETT",
        "credential": "MFT-INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI4090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA DRIVERS LICENSE",
            "identifier": "1704053355",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.