Provider Demographics
NPI:1568350619
Name:NORTH STAR WELLNESS
Entity type:Organization
Organization Name:NORTH STAR WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-265-2994
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:INDIAN SPRINGS
Mailing Address - State:NV
Mailing Address - Zip Code:89018-0185
Mailing Address - Country:US
Mailing Address - Phone:702-265-2994
Mailing Address - Fax:
Practice Address - Street 1:775 E WINSTON LN
Practice Address - Street 2:
Practice Address - City:INDIAN SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89018-0415
Practice Address - Country:US
Practice Address - Phone:702-265-2994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder