Alta Vista Mental Health LLC
Organization Active NPI Community/Behavioral Health Agency · Reno, NV
NPI 1992134472 · NPPES record last updated Aug 8, 2019
Key facts
- NPI
- 1992134472
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- ALTA VISTA MENTAL HEALTH LLC
- Practice address
- 1201 Terminal Way Ste 217
Reno, NV 89502-3258 - Phone
- (775) 624-8200
- Fax
- (775) 624-8222
- NPI assigned
- Nov 5, 2013
- Organization subpart
- No
Authorized official
- Name
- Christie White
- Title
- Ceo
- Phone
- (775) 624-8200
Practitioners 38
-
Brett William Copeland, LMFT
-
Shantell Marie Desmond, LMFT
-
Roger Hardin, MA
-
Dorothy Carol Wilkins, NCC, NCSC
-
Valerie Anna Zwyssig, LADC, MFT INTERN
-
Victoria Ann Grey, LCSW
-
Jessica Marie Link, LMSW, CSW-I
-
Kim Palchikoff, LMSW
-
Brandon Ruby, CSW-I
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171103002544 | NV | Part B Supplier - Clinic/Group Practice | 0042576274 |
Receives reassigned benefits from 7 practitioners Practice locations: Reno, NV |
National Provider Directory
Locations
6880 S McCarran Blvd
Ste 6
Reno, NV 89509
Phone (775) 437-5784
1201 Terminal Way
Ste 217
Reno, NV 89502
Phone (775) 624-8200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
1201 Terminal Way Ste 217
Reno, NV 89502-3258
Mailing address
1201 Terminal Way Ste 217
Reno, NV 89502-3258
Phone (775) 624-8200
NPI Registry JSON
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1565222400000",
"number": "1992134472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 TERMINAL WAY STE 217",
"city": "RENO",
"state": "NV",
"postal_code": "895023258",
"telephone_number": "775-624-8200",
"fax_number": "775-624-8222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 TERMINAL WAY STE 217",
"city": "RENO",
"state": "NV",
"postal_code": "895023258",
"telephone_number": "775-624-8200",
"fax_number": "775-624-8222"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALTA VISTA MENTAL HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-11-05",
"last_updated": "2019-08-08",
"status": "A",
"authorized_official_last_name": "WHITE",
"authorized_official_first_name": "CHRISTIE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "775-624-8200"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
- Jardine Alquero
- Ghayda Alrass
- Christina Alsop
- Amy Elizabeth Alspach
- Alta Vista Community Resource Center
- Amani Dimitrova Altamimi
- Nicole Altamirano
- Alternative Health, Prof L.L.C
- Peter Leonid Althausen
- Steven M Althoff
All providers in Reno, NV · Community/Behavioral Health Agency in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2019. 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.