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526 S Tonopah Dr Ste 140&160 Las Vegas NV 89106-4043 | |
| (702) 897-7250 | |
| (702) 706-4838 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 526 S Tonopah Dr Ste 140&160, Las Vegas, Nevada |
| Authorized Official Name and Position | John Reitano (OWNER) |
| Authorized Official Contact | 2152646147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
526 S Tonopah Dr Ste 140&160 Las Vegas NV 89106-4043 Ph: (702) 897-7250 | 526 S Tonopah Dr Ste 140&160 Las Vegas NV 89106-4043 Ph: (702) 897-7250 |
| NPI Number | 1013526979 |
|---|---|
| Provider Enumeration Date | 07/27/2020 |
| Last Update Date | 11/19/2024 |
| Certification Date | 11/19/2024 |
| Medicare PECOS PAC ID | 2365862406 |
|---|---|
| Medicare Enrollment ID | O20201012001642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013526979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | John Reitano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033285218 PECOS PAC ID: 3173892734 Enrollment ID: I20200324002809 |
| Provider Name | Bryan Michael Bender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669143517 PECOS PAC ID: 4789076126 Enrollment ID: I20220117000648 |
| Provider Name | Andrea S Call |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831481795 PECOS PAC ID: 0648417642 Enrollment ID: I20220713004248 |
| Provider Name | Nicole Ryan Hollister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487316311 PECOS PAC ID: 5890138374 Enrollment ID: I20240212003756 |
| Provider Name | Daphinee Austin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376007039 PECOS PAC ID: 0345687919 Enrollment ID: I20240319003009 |
| Provider Name | Hailee A Narayan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043885676 PECOS PAC ID: 4486191483 Enrollment ID: I20240808001745 |
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