LIFESTYLE OVERHAUL, LLC (NPI# 1821628199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821628199 |
| Entity Type | Organization |
| Organization Name | LIFESTYLE OVERHAUL, LLC |
| Practice Address |
98 E Lake Mead Pkwy Ste 201 Henderson NV 89015-6443 |
| Mailing Address |
820 Valley Brush St Henderson NV 89052-3812 |
| Practice Telephone | 7024333038 |
| Mailing Telephone | 7087523361 |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2020-01-24 |
| Authorized Official Name | MRS. CLAUDIA JOHNSON (PROFESSIONAL CLINICAL COUNSELOR) |
| Authorized Official Telephone | 7087523361 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 101YS0200X |
Counselor Specialization: School |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
98 E LAKE MEAD PKWY STE 201 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89015-6443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225503238 | Holly Abarca | Home Health Aide | 212 Shoshone Ln, Henderson, NV 89015 | 2018-10-05 |
| 1184111890 | Pain Center of Henderson LLC | Pain Medicine | 98 E. Lake Mead Pkwy. Suite 202, Henderson, NV 89015 | 2018-04-18 |
| 1124528963 | Edson Jeam Arredondo | Chore Provider | 160 E Horison Dr Ste A, Henderson, NV 89015 | 2018-02-19 |
| 1558879569 | Robin Harvey | Rehabilitation Practitioner | 203 S. Water St # 200, Henderson, NV 89015 | 2018-01-12 |
| 1477064368 | Chris Mcdonald | Counselor | 220 E Horizon Drive, Suite H, Henderson, NV 89015 | 2017-10-18 |
| 1649792565 | David Blake | Case Manager/Care Coordinator | 522 E. Lake Mead Parkway, Suite 5, Henderson, NV 89015 | 2017-07-12 |
| 1457726135 | Ozioma Chiebuka Nwosu | Nurse Practitioner | 200 E Horizon Dr Ste A, Henderson, NV 89015 | 2015-12-07 |
| 1770962839 | Myesha Nicole Butler | Counselor | 16 W. Pacific Street, Ste. 2, Henderson, NV 89015 | 2015-05-22 |
| 1629469424 | Felicia Suberville | Behavioral Analyst | 236 Red Horizon Terrace, Henderson, NV 89015 | 2015-02-16 |
| 1144618349 | Dinesh Bharwani | Physician Assistant | 270 West Lake Mead Parkway, Southwest Medical Associates, Henderson, NV 89015 | 2014-12-23 |
| Find all providers in zip 89015 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708310 | Heather Adams | Counselor | 915 Alper Center Dr Unit 3205, Henderson, NV 89052-1539 | 2020-10-18 |
| 1023627734 | Nicole R Vaughn Changing Minds | Counselor | 1070 Wigwam Pkwy Ste 120, Henderson, NV 89074-8193 | 2020-07-28 |
| 1710505722 | Christopher Flynn II | Counselor | 540 W Horizon Ridge Pkwy, Henderson, NV 89012-5202 | 2020-07-07 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1215551841 | Jacqueline Marie Villalobos | Counselor | 1404 Blaine Ranch St, Henderson, NV 89012-4805 | 2020-05-29 |
| 1750914792 | Charles Jacob Stockwell | Counselor | 2473 Bench Reef Pl, Henderson, NV 89052-5202 | 2020-02-18 |
| 1184260788 | Nathaniel Jacob Minetto | Counselor | 375 N Stephanie St # 8, Henderson, NV 89014-8771 | 2019-11-19 |
| 1225692965 | Jeannette Alina Cabagua | Counselor | 724 Bollons Island St, Henderson, NV 89002-0966 | 2019-04-29 |
| 1952862542 | Pervin N/a Gupta | Counselor | 2535 Binary Stars St, Henderson, NV 89044-4427 | 2019-03-27 |
| 1194289710 | Ernest Griego | Counselor | 2050 S Magic Way Spc 130, Henderson, NV 89002-8636 | 2019-01-28 |
| Find all providers in HENDERSON | ||||
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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.