Organization · NPI-2

1111 Therapy & Mental Health Institute

Counselor, Mental Health · Las Vegas, NV

NPI number1831863315

StatusActive

Last updated in NPPESAug 6, 2021

Details

NPI: 1831863315
Entity type: Organization (NPI-2)
Legal business name: 1111 Therapy & Mental Health Institute
Organization subpart: No
Enumeration date: Aug 6, 2021
Certification date: Aug 6, 2021
Last updated: Aug 6, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
101YM0800X	Counselor, Mental Health	–	–	Yes
101200000X	Drama Therapist	–	–
221700000X	Art Therapist	–	–
225400000X	Rehabilitation Practitioner	–	–
225600000X	Dance Therapist	–	–
225A00000X	Music Therapist	–	–
101Y00000X	Counselor	–	–
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
2084P0015X	Psychiatry & Neurology, Psychosomatic Medicine	–	–
225C00000X	Rehabilitation Counselor	–	–
251B00000X	Case Management	–	–
251S00000X	Community/Behavioral Health	–	–
3104A0630X	Assisted Living Facility, Assisted Living, Behavioral Disturbances	–	–
320800000X	Community Based Residential Treatment Facility, Mental Illness	–	–
320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–

Practice location

1504 Blackcombe St Unit 204
Las Vegas, NV 89128-8019

Phone 404-849-9918

Mailing address

1504 Blackcombe St Unit 204
Las Vegas, NV 89128-8019

Phone 404-849-9918

Authorized official

Rodney Bumpers
Manager
4048499918

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