Healthcare Provider Details

I. General information

NPI: 1639013287
Provider Name (Legal Business Name): FENTANES MENTAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3224 VENTANA HILLS DR
LAS VEGAS NV
89117-0103
US

IV. Provider business mailing address

3224 VENTANA HILLS DR
LAS VEGAS NV
89117-0103
US

V. Phone/Fax

Practice location:
  • Phone: 562-781-4813
  • Fax:
Mailing address:
  • Phone: 562-781-4813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SUSANA FENTANES
Title or Position: OWNER
Credential: CPC
Phone: 562-781-4813