State of Nevada
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Gardnerville, NV
NPI 1972684355 · NPPES record last updated Nov 14, 2022
Key facts
- NPI
- 1972684355
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- STATE OF NEVADA
- Practice address
- 1538 Hwy 395 N
Ste 100
Gardnerville, NV 89410-5265 - Phone
- (775) 687-2160
- Fax
- (775) 782-6639
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Elle Richardson-Adams
- Title
- Agency Manager
- Phone
- (702) 486-4400
Other NPIs on the same Medicare enrollment 15
Corporate family (same tax ID) 14
Practitioners 13
-
Joshua Nelsen, PMHNP-BC
-
Erika Ryst, M.D.
-
Noah David Yaeger, APRN, PMHNP-BC
-
Sean Dodge, PSY.D.
-
Richard Bissett, PHD
-
Tracy Cassity, LCSW
-
John J Cerny, RN, LADC
-
Carol S Dillingham, PHD
-
Mary Mackenzie, RN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040212000160 | NV | Part B Supplier - Clinic/Group Practice | 9234022153 |
Receives reassigned benefits from 146 practitioners 15 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Yerington, NV; Winnemucca, NV; Tonopah, NV; Sparks, NV; Silver Springs, NV; Pahrump, NV; Mesquite, NV; Lovelock, NV… |
National Provider Directory
- Tax ID family
- Nevada State Health Division
Locations
215 W Bridge St
Ste 5
Yerington, NV 89447
Phone (775) 463-3191
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
1538 Hwy 395 N
Ste 100
Gardnerville, NV 89410-5265
Mailing address
Attn: Cyndi Smith
240 S. Humahuaca
Pahrump, NV 89048-2199
Phone (775) 751-7406
Other names
- DOUGLAS MENTAL HEALTH CENTER
- Rural Clinics Douglas
Other providers in Gardnerville, NV
- Ashley Renee Sohler
- Scott Wilson Southard
- Bonnie Rose Spradley
- Michelle Sscot
- State of Nevada
- Matthew Patrick Stevens
- Kathryn Marie Stevenson
- Robert William Stone
- Daniel Wade Stratton
- Elspeth Summersgill
All providers in Gardnerville, NV · Mental Health Clinic/Center (Including Community Mental Health Center) in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.