Healthcare Provider Details

I. General information

NPI: 1154995082
Provider Name (Legal Business Name): RESTING MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2021
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4623 W DESERT INN RD
LAS VEGAS NV
89102-7116
US

IV. Provider business mailing address

4623 W DESERT INN RD
LAS VEGAS NV
89102-7116
US

V. Phone/Fax

Practice location:
  • Phone: 702-410-9629
  • Fax: 702-410-9644
Mailing address:
  • Phone: 702-410-9629
  • Fax: 702-410-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA WADSWORTH
Title or Position: OWNER
Credential: LMFT
Phone: 702-410-9629