Individual provider Active NPI

Michelle Gray Heinhold, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1912977703
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2822-C Issued in NV
Practice address
9159 W Flamingo Rd #106
Las Vegas, NV 89147
Phone
(702) 496-1135
Fax
(888) 780-3217
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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 2822-C NV Primary

Addresses

Primary practice location

9159 W Flamingo Rd #106
Las Vegas, NV 89147

Mailing address

9159 W Flamingo Rd #106
Las Vegas, NV 89147
Phone (702) 496-1135

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
I20200903003395 NV Practitioner - Clinical Social Worker 8820423395 Practice locations: Las Vegas, NV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6268 S Rainbow Blvd
Suite 110
Las Vegas, NV 89118-3241
Phone (702) 496-1135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1912977703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9159 W FLAMINGO RD #106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89147",
            "telephone_number": "702-496-1135",
            "fax_number": "888-780-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9159 W FLAMINGO RD #106",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89147",
            "telephone_number": "702-496-1135",
            "fax_number": "888-780-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINHOLD",
        "first_name": "MICHELLE",
        "middle_name": "GRAY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "2822-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.