Individual provider Active NPI

Dominique James Walker

  • Mental Health Counselor
  • Las Vegas, NV
National Provider Identifier
1831515428
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
20111675665 Issued in NV
Practice address
1333 N Buffalo Dr Ste 25
Las Vegas, NV 89128-3634
Phone
(702) 354-0017
NPI assigned
Mar 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 20111675665 NV Primary

Addresses

Primary practice location

1333 N Buffalo Dr Ste 25
Las Vegas, NV 89128-3634

Mailing address

1333 N Buffalo Dr Ste 25
Las Vegas, NV 89128-3634

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
20111675665NVMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1831515428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 N BUFFALO DR STE 25",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 N BUFFALO DR STE 25",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283634",
            "telephone_number": "702-354-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DOMINIQUE",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "20111675665",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 7, 2014; 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.