Tamara Ann Hernandez, CPC-I, MSCRMHC, BS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1040 Juniper Ridge Ave
Henderson, NV 89015-6902

Phone

(702) 809-7748

NPI assigned

Sep 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Tamara Ann Mullis Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

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    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1922581396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 E PATRICK LN STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891204902",
            "telephone_number": "702-810-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 JUNIPER RIDGE AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890156902",
            "telephone_number": "702-809-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "TAMARA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CPC-I, MSCRMHC, BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2024-02-28",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED BEHAVIOR TECHNICIAN",
            "identifier": "1922581396",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922581396",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.beautifulbalancecounseling.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "1040 Juniper Ridge Ave",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890156902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.beautifulbalancecounseling.com",
            "affiliation": "N",
            "endpointDescription": "SimplePracticeWebsite",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHI",
            "address_1": "1040 Juniper Ridge Ave",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890156902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "MULLIS",
            "middle_name": "ANN",
            "credential": "CPC-I, MSCRMHC, ASDI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Malyssa D Hernandez, APRN
• Maria Elena Hernandez
• Myra Jannet Hernandez
• Piper D Hernandez
• Stephanie Hernandez, RBT
• Vicky Yvette Hernandez Jr.
• Gertrudes Hernando
• Charles Chandler Herndon
• Debra Kay Hernlund, IBCLC
• Heroes of America Foundation, Inc.

• Mental Health Counselor in Henderson, NV
• Providers in Henderson, 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 Feb 28, 2024; 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.