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VEGAS INNOVATIVE PSYCHIATRY
NPI 1053931576
Clinic/Center - Multi-Specialty in Las Vegas, NV

Active since April 24, 2020
1721 E CHARLESTON BLVD, LAS VEGAS, NV 89104(702) 685-0620(702) 685-9674 Get Directions Write a Review

NPPES record last updated: August 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 3, 2020, Apr 24, 2020 (2 updates tracked since 2020).

About Vegas Innovative Psychiatry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VEGAS INNOVATIVE PSYCHIATRY (NPI 1053931576) is a healthcare organization registered as a multi-specialty in Las Vegas, Nevada and active in the NPI registry since April 2020. The organization lists Maria Fernanda Mitchell, Program Director, as its authorized official.

NPPES Registry Identity

NPI1053931576
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameVEGAS INNOVATIVE PSYCHIATRY
Location Address1721 E CHARLESTON BLVDLas Vegas, NV 89104-1902
Mailing Address1721 E Charleston BlvdLas Vegas, NV 89104-1902 · (702) 685-0620 · Fax (702) 685-9674
Phone(702) 685-0620
Fax(702) 685-9674
Organization SubpartNo
Authorized OfficialMaria Fernanda MitchellProgram Director · (702) 580-1850
Enumeration DateApril 24, 2020
Last NPPES UpdateAugust 3, 20202 updates tracked since enumeration
NPPES CertifiedAugust 3, 2020
✔ NPI 1053931576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1721 E CHARLESTON BLVD, Las Vegas, NV 89104
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Other Names 1

Doing Business AsVegas Innovative Psychiatry

Other Identifiers 1

MedicaidE6055912020-0NV

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OZOMOR LLC
Clinic/Center (Primary Care)
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 515-9680
EBONNY VENTURES LLC
Psychiatry & Neurology (Psychiatry)
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 515-9680
LAURA E GRIFFIN QMHA
Counselor (Professional)
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 685-0620
MELISA STEPHENS
Community Health Worker
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 685-0620
NEVADA INTEGRATED BEHAVIORAL SERVICES INC.
Clinic/Center (Rehabilitation, Substance Use Disorder)
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County No phone listed
JOHN NDUBUISI UDO FNP, APRN
Nurse Practitioner (Family)
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 685-0620
ADELA NEDZWECKAS A.A, B.A
Community Health Worker
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 685-0620
NEVADA INTEGRATED BEHAVIORAL SERVICES INC.
Social Worker
1721 E CHARLESTON BLVD
LAS VEGAS, NV 89104
Clark County (702) 515-9680

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vegas Innovative Psychiatry's NPI number?

The NPI number for Vegas Innovative Psychiatry is 1053931576. It was assigned to this organization in the NPPES registry on April 24, 2020.

Where is Vegas Innovative Psychiatry located?

Vegas Innovative Psychiatry is located at 1721 E Charleston Blvd, Las Vegas, NV 89104. The listed phone number is (702) 685-0620.

What is Vegas Innovative Psychiatry's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Vegas Innovative Psychiatry was last updated on August 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.