MEDICARE: MENTAL WELLNESS SOLUTIONS LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1134874431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL WELLNESS SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4843 STEPHANIE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-6138
Country	:	US
Telephone Number	:	702-426-0626
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 E FLAMINGO RD STE 119
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0800
Country	:	US
Telephone Number	:	702-426-0626
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MERCEDES CARDENAS
Credential	:
Telephone Number	:	702-426-0626

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	02/15/2022

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Directions to “MENTAL WELLNESS SOLUTIONS LLC ” Practice Location

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