WELLPSYCHE MEDICAL GROUP PC (NPI# 1861055956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861055956 |
| Entity Type | Organization |
| Organization Name | WELLPSYCHE MEDICAL GROUP PC |
| Practice Address |
871 Coronado Center Dr Ste 200 Henderson NV 89052-3977 |
| Mailing Address |
1055 Wilshire Blvd Ste 1705 Los Angeles CA 90017-5600 |
| Practice Telephone | 9494002488 |
| Mailing Telephone | 3108710670 |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-04-15 |
| Authorized Official Name | DR. ADEL MOSTAFAVI (CEO) |
| Authorized Official Telephone | 9494002488 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
871 CORONADO CENTER DR STE 200 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-3977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649574096 | Sharon Alene Russell | Counselor | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2010-12-28 |
| 1649885377 | A and R Hospice, Inc. | Hospice Care, Community Based | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2020-09-10 |
| 1568077295 | Apa Hospice Care, Inc. | Hospice Care, Community Based | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2020-09-10 |
| 1225668072 | Cassidy & Parise | Counselor | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2020-01-21 |
| 1952941304 | Heroes of America Foundation, Inc. | Case Manager/Care Coordinator | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2020-01-14 |
| 1538712351 | Meridian Counseling Services | Counselor | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2019-07-21 |
| 1730745381 | Magnolia Counseling LLC | Social Worker | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2019-05-18 |
| 1922560341 | Christina Parise, LLC | Social Worker | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2019-04-03 |
| 1275039430 | Cory Pearce, Phd, Ltd | Psychologist | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2018-04-04 |
| 1366943227 | Casa Medical Hospitalist LLC | Nurse Practitioner | 871 Coronado Center Dr Ste 200, Henderson, NV 89052-3977 | 2018-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043424443 | Rico Fontillas Inc | Psychiatry & Neurology | 1090 Wigwam Parkway, #100, Henderson, NV 89074 | 2007-05-09 |
| 1982629762 | Ricardo Allen Fontillas | Psychiatry & Neurology | 1090 Wigwam Pkwy, Suite 100, Henderson, NV 89074-8181 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164873246 | Lisa A Durette Md Pllc | Psychiatry & Neurology | 526 S Tonopah Dr Ste 210, Las Vegas, NV 89106-4043 | 2016-06-29 |
| 1720472327 | Fernando Mendez | Psychiatry & Neurology | 2021 S. Jones Blvd, Las Vegas, NV 89146 | 2015-03-23 |
| 1265774921 | Amanda Lauren Melone | Psychiatry & Neurology | 2900 Sandestin Dr, Reno, NV 89523-2137 | 2013-03-20 |
| 1063760411 | Uzoma C Osuchukwu | Psychiatry & Neurology | 4310 W Cheyenne Ave Ste 100, N Las Vegas, NV 89032-2484 | 2012-08-16 |
| 1447359955 | Lisa Ann Durette | Psychiatry & Neurology | 6375 W Charleston Blvd Ste A-100, Las Vegas, NV 89146-1139 | 2006-09-21 |
| 1598860306 | Arden D Dingle | Psychiatry & Neurology | 5190 Neil Rd Ste 215, Reno, NV 89502-6509 | 2006-09-14 |
| 1255342069 | Joan Rueter Carapucci | Psychiatry & Neurology | 2775 S. Jones Blvd, Suite 101, Las Vegas, NV 89146 | 2006-08-10 |
| 1457303828 | Ann Childress | Psychiatry & Neurology | 4000 E. Charleston Blvd., B-130, Las Vegas, NV 89104 | 2006-05-16 |
| 1083239925 | Physicians of America | Psychiatry & Neurology | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2020-06-16 |
| 1659900041 | Harding Pinnacle Psychiatric Care PC | Psychiatry & Neurology | 9414 W Lake Mead Blvd, Las Vegas, NV 89134-8312 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WELLPSYCHE MEDICAL GROUP PC.
| 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.