MEDICARE: MENTAL HEALTH COUNSELING AND WELLNESS CENTER INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician

General Provider Information

NPI Number	:	1588140883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH COUNSELING AND WELLNESS CENTER INC.

Provider Business Mailing Address
First Line	:	320 E WARM SPRINGS RD, UNIT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:	702-602-5250
Fax Number	:	702-602-5251

Provider Business Practice Location Address
First Line	:	320 E WARM SPRINGS RD UNIT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:	702-602-5250
Fax Number	:	702-602-5251

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARTIN BINYANGE
Credential	:	DNP
Telephone Number	:	702-602-5250

Provider Enumeration Date	:	07/19/2018
Last Update Date	:	08/04/2022

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