Provider Demographics
NPI:1497276232
Name:MENTAL HEALTH COUNSELING AND WELLNESS CENTER INC.
Entity Type:Organization
Organization Name:MENTAL HEALTH COUNSELING AND WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BINYANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:702-602-5250
Mailing Address - Street 1:320 E WARM SPRINGS RD, UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4243
Mailing Address - Country:US
Mailing Address - Phone:702-602-5250
Mailing Address - Fax:702-602-5251
Practice Address - Street 1:320 E WARM SPRINGS RD UNIT 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4243
Practice Address - Country:US
Practice Address - Phone:702-602-5250
Practice Address - Fax:702-602-5251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-02
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV52423Medicaid