| Symphony Mind Llc | |
|
2619 W Charleston Blvd Ste D Las Vegas NV 89102-2121 | |
| (702) 559-7801 | |
| Not Available |
| Full Name | Symphony Mind Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2619 W Charleston Blvd Ste D, Las Vegas, Nevada |
| Authorized Official Name and Position | Joel Hernandez (MANAGER) |
| Authorized Official Contact | 7253011182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Symphony Mind Llc 2619 W Charleston Blvd Ste D Las Vegas NV 89102-2121 Ph: (725) 301-1182 | Symphony Mind Llc 2619 W Charleston Blvd Ste D Las Vegas NV 89102-2121 Ph: (702) 559-7801 |
| NPI Number | 1669184412 |
|---|---|
| Provider Enumeration Date | 12/22/2022 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 3375996564 |
|---|---|
| Medicare Enrollment ID | O20240124000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669184412 | NPI | - | NPPES |
| 2916 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Maria Mondonedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356052765 PECOS PAC ID: 8628423738 Enrollment ID: I20231010001937 |
| Provider Name | Daina Chiappe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114358868 PECOS PAC ID: 9133560022 Enrollment ID: I20240509001108 |
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