RESURRECTION ENTERPRISE, LLC (NPI# 1902187735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902187735 |
| Entity Type | Organization |
| Organization Name | RESURRECTION ENTERPRISE, LLC |
| Practice Address |
1448 E Charleston Blvd Las Vegas NV 89104-1705 |
| Mailing Address |
Po Box 12924 Las Vegas NV 89112-0924 |
| Practice Telephone | 7023824061 |
| Mailing Telephone | 7023824061 |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2016-01-05 |
| Authorized Official Name | MS. PHUNG HORTON JEFFERSON (MANAGING MEMBER) |
| Authorized Official Telephone | 7023824061 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
1448 E CHARLESTON BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89104-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982075057 | Tommy Bailey | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2015-10-14 |
| 1013312404 | Sheldy Johana Santos | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-10-28 |
| 1487059879 | Danielle Claudine Reyes | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-10-27 |
| 1205231693 | Abiel Abraham Brinkley | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-10-27 |
| 1851792246 | Taina Muhammad | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-09-04 |
| 1518375492 | Jenyffer Yeraldine Guillen-santiaguin | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-07-23 |
| 1447667589 | Robert Foreman | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-07-21 |
| 1710394002 | Darryle Lynn Willoughby II | Behavioral Analyst | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-07-18 |
| 1275949661 | Paula Kae Rudeen | Counselor | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-07-07 |
| 1699186056 | Louis Radford | Counselor | 1448 E Charleston Blvd, Las Vegas, NV 89104-1705 | 2014-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550635 | Comfort Care Senior Services LLC | In Home Supportive Care | 1601 S Sandhill Rd, 62, Las Vegas, NV 89104 | 2020-08-26 |
| 1508484734 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1405 South Mojave Rd, Las Vegas, NV 89104 | 2020-07-14 |
| 1003448333 | Shirley Lauren Valenzona-gianan | Pharmacist | Smith's Pharmacy #318, 4965 East Sahara Avenue, Las Vegas, NV 89104 | 2020-02-05 |
| 1427602713 | Alma Lucia Lozano-vargas | Chore Provider | 1785 E. Sahara Ave. Suite 485, Las Vegas, NV 89104 | 2019-07-25 |
| 1396398947 | Martinez Antuan Coates | Psychologist | 1755 Palm St Bld T Apt147, Las Vegas, NV 89104 | 2019-07-23 |
| 1982171518 | Ian Sande | Occupational Therapist | 1500 West Warm Springs Rd, Las Vegas, NV 89104 | 2018-11-01 |
| 1215436563 | A Better Life In Home Care, LLC | Technician | 1810 East Sahara Avenue, Suite 216, Las Vegas, NV 89104 | 2018-02-01 |
| 1891202016 | Nevada Helping Hands LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1810 E Sahara Ave Ste 143, Las Vegas, NV 89104 | 2018-01-09 |
| 1760901581 | Fannie Bell | Counselor | 1800 E. Sahara Suite 104, Las Vegas, NV 89104 | 2017-09-13 |
| 1386162147 | Jaclyn Mustachio | Social Worker | 1860 E Sahara Ave, Las Vegas, NV 89104 | 2017-08-31 |
| Find all providers in zip 89104 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154933067 | Michelle Rocha | Social Worker | 5912 Kit Cove Ct, Las Vegas, NV 89131-2088 | 2020-08-21 |
| 1720697980 | Christian Scott | Social Worker | 4055 Spencer St #118, Las Vegas, NV 89119 | 2020-07-23 |
| 1376161315 | Depth Psychological Services | Social Worker | 10616 Zingali Ct, Las Vegas, NV 89141-4251 | 2020-07-07 |
| 1659993475 | Judith Rosen | Social Worker | 220 E Flamingo Rd Unit 423, Las Vegas, NV 89169-0306 | 2020-05-14 |
| 1912529066 | Stacy Ilene Benham | Social Worker | 2601 S Grand Canyon Dr Apt 2003, Las Vegas, NV 89117-3671 | 2020-05-12 |
| 1851912539 | Angelique Charity Murguia | Social Worker | 7928 Rushmore Ave, Las Vegas, NV 89131-1552 | 2020-05-04 |
| 1639703598 | Lauren Fousek | Social Worker | 610 S Rancho Drive, #a10, Las Vegas, NV 89106-8910 | 2020-02-28 |
| 1780217679 | 58 10 Behavioral Health Services Pllc | Social Worker | 1810 E Sahara Ave Ste 212 373, Las Vegas, NV 89104-3707 | 2020-02-19 |
| 1801428602 | Chasstiry Vazquez | Social Worker | 2215 Renaissance Dr Ste C, Las Vegas, NV 89119-6729 | 2020-02-10 |
| 1437707486 | Charlene Miranda Paule | Social Worker | 2340 Paseo Del Prado Ste D110, Las Vegas, NV 89102-4340 | 2019-09-03 |
| 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.