LISA DURETTE MD PLLC (NPI# 1235633421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235633421 |
| Entity Type | Organization |
| Organization Name | LISA DURETTE MD PLLC |
| Other Organization Name | HEALTHY MINDS |
| Practice Address |
526 S Tonopah Dr Ste 200 Las Vegas NV 89106-4013 |
| Mailing Address |
Po Box 82038 Las Vegas NV 89180-2038 |
| Practice Telephone | 7026460188 |
| Mailing Telephone | 7023599899 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2020-05-14 |
| Authorized Official Name | LISA ANN DURETTE (OWNER) |
| Authorized Official Telephone | 7022342772 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Healthy Minds | Doing Business As Name - Organization |
| Lisa Durette MD PLLC | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3551 E Bonanza Rd Ste 101, Las Vegas, NV 891102198 | 7026460188 | |
| 526 S Tonopah Dr Ste 200, Las Vegas, NV 891064013 | 7026460188 |
| Street Address |
526 S TONOPAH DR STE 200 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669679205 | Lisa A Durette Md Pllc | Counselor | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2007-06-28 |
| 1083239925 | Physicians of America | Psychiatry & Neurology | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2020-06-16 |
| 1558907907 | Lisa A Durette Md Pllc | Clinical Nurse Specialist | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2019-11-20 |
| 1164992772 | Jana Grabenstein | Case Manager/Care Coordinator | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2018-11-27 |
| 1144724410 | Brittany Polk | Counselor | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2018-03-21 |
| 1740691385 | David Y. Brownstein | Psychologist | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2014-05-16 |
| 1588097570 | Stephanie Michelle Pineda | Counselor | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2013-08-14 |
| 1700124898 | Rebecca Theresa Louise Nemecek | Counselor | 526 S Tonopah Dr Ste 200, Las Vegas, NV 89106-4013 | 2013-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
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| 1811532781 | Melanie Fedraw | Counselor | 3661 S Maryland Pkwy Ste 64, Las Vegas, NV 89169-3005 | 2019-11-14 |
| 1457906729 | Elizabeth Ann Morris | Counselor | 7408 Mountain Thicket St, Las Vegas, NV 89131-4542 | 2019-08-05 |
| 1902450455 | Tracey Anora Henry | Counselor | 3675 Pecos Mecleod Ste 900, Las Vegas, NV 89121 | 2019-08-01 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.