RICHARD GERARD BRODMERKEL (NPI# 1629638184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629638184 |
| Entity Type | Individual |
| Full Name | RICHARD GERARD BRODMERKEL |
| Credential | PEER ADVOCATE |
| Practice Address |
1600 E Desert Inn Rd Ste 104 Las Vegas NV 89169-2505 |
| Practice Telephone | 7022082194 |
| Mailing Telephone | 7022082194 |
| Mailing Fax Number | 7022082208 |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | NY | Other Service Providers |
| Street Address |
1600 E DESERT INN RD STE 104 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89169-2505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114301504 | Edmina Saldua | Counselor | 1600 E Desert Inn Rd Ste 104, Las Vegas, NV 89169-2505 | 2015-07-15 |
| 1295211126 | Great Mind Counseling and Wellness Center | Psychiatry & Neurology | 1600 E Desert Inn Rd Ste 104, Las Vegas, NV 89169-2505 | 2018-07-13 |
| 1922558451 | Phalen Pounds | Behavior Technician | 1600 E Desert Inn Rd Ste 104, Las Vegas, NV 89169-2505 | 2016-10-07 |
| 1982050084 | Vivien Brock | Counselor | 1600 E Desert Inn Rd Ste 104, Las Vegas, NV 89169-2505 | 2016-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038196 | Tammy E Smith | Home Health | 1500 Karen Ave, 65, Las Vegas, NV 89169 | 2020-09-16 |
| 1457978561 | Damon Lavell Cohran | Counselor | 459 Sierra Vista Dr, 32, Las Vegas, NV 89169 | 2020-07-06 |
| 1912543307 | Josephine R Hernandez | Rehabilitation Practitioner | Firstmed Health and Wellness Center Inc., 3343 S. Eastern Avenue, Las Vegas, NV 89169 | 2019-11-21 |
| 1528602174 | Cindy Pena Jaramillo | Technician | 3376 S. Eaatern Ave, Las Vegas, NV 89169 | 2019-11-06 |
| 1497309967 | Richard Snarr Worthen | Technician | 3175 South Eastern Ave, Las Vegas, NV 89169 | 2019-08-01 |
| 1447718796 | Hope Industries LLC | Chore Provider | 1711 E Desert Inn Rd, Las Vegas, NV 89169 | 2019-03-06 |
| 1609345321 | Diaz Health LLC | Community/Behavioral Health | 5225 West 2nd Street, Las Vegas, NV 89169 | 2018-11-26 |
| 1902371024 | Kevin Burnett | Technician | 1100 Dunmont Apt 202, Las Vegas, NV 89169 | 2018-10-04 |
| 1659865111 | Kimberly Jackson-hampton | Counselor | 335 E Harmon Ave Apt 30, Las Vegas, NV 89169 | 2018-06-19 |
| 1093216350 | Blessed Services LLC | Community/Behavioral Health | 2525 White Street, Las Vegas, NV 89169 | 2018-02-22 |
| Find all providers in zip 89169 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518505536 | Ashley A Robinson | Peer Specialist | 2011 Pinto Lane Suite 200, Las Vegas, NV 89106-4007 | 2019-12-20 |
| 1972116929 | Renato Lucas Gerona Navarro-schlegel | Peer Specialist | 4221 Mcleod Dr, Las Vegas, NV 89121-5215 | 2020-08-28 |
| 1023674702 | Mark D Livingston | Peer Specialist | 2301 7th St Ste A, Las Vegas, NM 87701-4966 | 2019-05-17 |
| 1124527551 | Gustavo Cancino | Peer Specialist | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2018-02-12 |
| 1073013413 | Susana Lopez | Peer Specialist | 1640 Alta Dr, Las Vegas, NV 89106-4163 | 2018-02-12 |
| 1841790292 | Wendy Farko | Peer Specialist | 1640 Alta Dr Ste 4, Las Vegas, NV 89106-4165 | 2018-02-12 |
| 1184149460 | Braedan Singh | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-08 |
| 1184149809 | Billy Joe West | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-03 |
| 1407371123 | Katherine Ann Moore | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-03 |
| 1437674140 | Christopher Foltz | Peer Specialist | 323 N Maryland Pkwy, Las Vegas, NV 89101-3130 | 2017-08-03 |
| 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.