Mrtherapy Wellness Space, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MRTHERAPY WELLNESS SPACE, LLC

Practice address

851 S Rampart Blvd Ste 130
Las Vegas, NV 89145-4884

Phone

(702) 854-2168

Fax

(702) 854-2168

NPI assigned

Jul 21, 2022

Organization subpart

Yes

Parent organization

MRTHERAPY, LLCAs reported in NPPES

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

Authorized official

Name

Michele Ramey, LMFT

Title

Ceo

Phone

(702) 854-2168

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831824903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S JONES BLVD # 4700",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072623",
            "telephone_number": "702-854-2168",
            "fax_number": "702-854-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S RAMPART BLVD STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454884",
            "telephone_number": "702-854-2168",
            "fax_number": "702-854-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRTHERAPY WELLNESS SPACE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MRTHERAPY, LLC",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "RAMEY",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-854-2168",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEVADA BOARD OF EXAMINERS FOR MFT'S AND CPC'S",
            "identifier": "3234-R",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.