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BROKENSHELLS CONSULTING LLC NPI 1790357648


NPI Information

NPI: 1790357648
Provider Name: BROKENSHELLS CONSULTING LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
800 N RAINBOW BLVD STE 208
LAS VEGAS, NV
ZIP 89107
Phone: (404) 428-0019
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BROKENSHELLS CONSULTING LLC is a mental health (including community mental health center) clinic center in Las Vegas, NV. BROKENSHELLS CONSULTING LLC NPI is 1790357648. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

800 N RAINBOW BLVD STE 208
LAS VEGAS, NV
ZIP 89107-193
Phone: (404) 428-0019

The provider's authorized official is Jazmine Smith .
The authorized official title is Owner and has the following contact phone number (404) 428-0019.

The enumeration date for this NPI number is 7/12/2021 and was last updated on 7/12/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
182-2143136MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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