Active NPI
Edward Holly
- Mental Health Counselor
- Las Vegas, NV
National Provider Identifier
1932071990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C15209
- Practice address
- 3680 N Rancho Dr
Las Vegas, NV 89130-3180 - Phone
- (702) 646-5437
- NPI assigned
- Sep 19, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C15209 | NV | Primary |
Addresses
Primary practice location
3680 N Rancho Dr
Las Vegas, NV 89130-3180
Mailing address
9340 Shawnee Mission Ave
Las Vegas, NV 89178-5514
Phone (702) 275-5567
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
| License | State | Type | Specialty |
|---|---|---|---|
| C15209 | NV | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758240000000",
"number": "1932071990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9340 SHAWNEE MISSION AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891785514",
"telephone_number": "702-275-5567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3680 N RANCHO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891303180",
"telephone_number": "702-646-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLY",
"first_name": "EDWARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-19",
"last_updated": "2025-09-19",
"certification_date": "2025-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "C15209",
"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 Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.