Provider Demographics
NPI:1265703441
Name:PERSON-HOLISTIC INNOVATIONS (PHI), LLC
Entity type:Organization
Organization Name:PERSON-HOLISTIC INNOVATIONS (PHI), LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BERARDUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, ACS
Authorized Official - Phone:814-397-6793
Mailing Address - Street 1:PO BOX 35586
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5586
Mailing Address - Country:US
Mailing Address - Phone:702-518-4532
Mailing Address - Fax:
Practice Address - Street 1:7041 SUNHAMPTON AVE UNIT 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-1735
Practice Address - Country:US
Practice Address - Phone:702-518-4532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20111369130251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty