MRS. PEGGY SUE BLACK (NPI# 1518300946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518300946 |
| Entity Type | Individual |
| Full Name | MRS. PEGGY SUE BLACK |
| Other Name | MRS. PEGGY SUE BLACK |
| Credential | LCPC |
| Practice Address |
2300 W Bonanza Rd Las Vegas NV 89106-4718 |
| Mailing Address |
5458 Petaca Rd Las Vegas NV 89122-3389 |
| Practice Telephone | 7026475842 |
| Practice Fax Number | 7026474497 |
| Mailing Telephone | 7028581986 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2020-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
00464-LC | NV | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
CP-0215 | NV | Behavioral Health & Social Service Providers |
| N | 225400000X | Rehabilitation Practitioner | CP-0215 | NV | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 1518300946 | 05 |
| Street Address |
2300 W BONANZA RD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407152606 | Sandra Carter | Counselor | 2300 W Bonanza Rd, Las Vegas, NV 89106-4718 | 2011-02-04 |
| 1669819298 | Merlyn Arthur Sexton | Counselor | 2300 W Bonanza Rd, Las Vegas, NV 89106-4718 | 2013-05-22 |
| 1306282835 | Lloyd Robert Kenne | Counselor | 2300 W Bonanza Rd, Las Vegas, NV 89106-4718 | 2013-05-10 |
| 1982049482 | Judye R Marshall | Counselor | 2300 W Bonanza Rd, Las Vegas, NV 89106-4718 | 2013-05-09 |
| 1154664464 | Las Vegas Indian Center Inc | Voluntary or Charitable | 2300 W Bonanza Rd, Las Vegas, NV 89106-4718 | 2013-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497839 | Joseph Javier | Counselor | 526 S Tonopah Dr Ste 140, Las Vegas, NV 89106-4044 | 2020-11-05 |
| 1881206605 | Healing and Wholeness | Counselor | 9634 Hawk Cliff Ave, Las Vegas, NV 89148-4716 | 2020-08-21 |
| 1396356929 | A-plus Community Counseling Services LLC | Counselor | 3651 S Lindell Dr Ste D15, Las Vegas, NV 89103 | 2020-08-17 |
| 1700408978 | New Perspectives Behavioral Health LLC | Counselor | 725 Jacobs Ladder Pl, Las Vegas, NV 89138-7540 | 2020-05-11 |
| 1265075139 | Dennis Patrick Smith | Counselor | 2225 E Flamingo Rd Ste 102, Las Vegas, NV 89119-5126 | 2019-10-23 |
| 1083268577 | Taylor D Bull | Counselor | 7251 Vireo Dr, Las Vegas, NV 89147-4645 | 2019-08-01 |
| 1801351440 | Kathleen Marie Davis | Counselor | 2574 Olay St, Las Vegas, NV 89142-2801 | 2019-02-07 |
| 1770048613 | Natalie King | Counselor | 7260 Las Vegas Blvd S # 210, Las Vegas, NV 89119-4020 | 2019-02-05 |
| 1699257402 | Beth Asaf | Counselor | 2309 Renaissance Dr Ste B, Las Vegas, NV 89119-6160 | 2018-08-29 |
| 1659865111 | Kimberly Jackson-hampton | Counselor | 335 E Harmon Ave Apt 30, Las Vegas, NV 89169 | 2018-06-19 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.