Healthcare Provider Details

I. General information

NPI: 1033902960
Provider Name (Legal Business Name): BHSND-PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 32ND AVE S STE 102
FARGO ND
58103-5911
US

IV. Provider business mailing address

2200 PASEO VERDE PKWY STE 190
HENDERSON NV
89052-2703
US

V. Phone/Fax

Practice location:
  • Phone: 702-589-4871
  • Fax:
Mailing address:
  • Phone: 702-589-4871
  • Fax: 702-589-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KRISTA HUEY
Title or Position: LEAD CREDENTIALING SPECIALIST
Credential: LEAD
Phone: 702-528-9947