Provider Demographics
NPI:1912501883
Name:DESERT GRIT MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:DESERT GRIT MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:DUNNAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LCPC, LPCC,SAP
Authorized Official - Phone:702-899-1950
Mailing Address - Street 1:187 E WARM SPRINGS RD STE B157
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4110
Mailing Address - Country:US
Mailing Address - Phone:702-899-1950
Mailing Address - Fax:725-999-1013
Practice Address - Street 1:187 E WARM SPRINGS RD STE B157
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4110
Practice Address - Country:US
Practice Address - Phone:702-899-1950
Practice Address - Fax:725-999-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760901383OtherNPI -INDIVIDUAL
1760901383OtherNPI -INDIVIDUAL