Organization Active NPI

Holistic Wellness Center LLC

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1942026430
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HOLISTIC WELLNESS CENTER LLC
Practice address
4055 Spencer St Ste 206
Las Vegas, NV 89119-5251
Phone
(702) 906-6185
NPI assigned
Nov 29, 2024
Last updated
Nov 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

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

Authorized official

Name
Patricia Escutary
Title
Owner
Phone
(702) 906-6185

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

4055 Spencer St Ste 206
Las Vegas, NV 89119-5251

Mailing address

8081 Minots Ledge Ave
Las Vegas, NV 89147-4787

National Provider Directory

National Provider Directory

Locations

4055 Spencer St
Ste 206
Las Vegas, NV 89119
Phone (702) 906-6185

NPI Registry JSON

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

{
    "created_epoch": "1732838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732838400000",
    "number": "1942026430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 MINOTS LEDGE AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891474787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 SPENCER ST STE 206",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195251",
            "telephone_number": "702-906-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-29",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A",
        "authorized_official_last_name": "ESCUTARY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-906-6185"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 29, 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.