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Organization
DIVINE WELLNESS LAS VEGAS
Active
Organization
DIVINE WELLNESS LAS VEGAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN GIST (OWNER)
(702) 292-4073
Entity
Organization
Contact information
Practice address
6960 OBANNON DR STE 110, LAS VEGAS, NV 89117-2160
(702) 292-4073
Mailing address
6960 OBANNON DR STE 110, LAS VEGAS, NV 89117-2160
(702) 292-4073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/09/2026
Last updated
04/06/2026
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