Provider Demographics
| NPI: | 1033908413 |
|---|---|
| Name: | ARTFUL LIVES |
| Entity type: | Organization |
| Organization Name: | ARTFUL LIVES |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | MANAGING MEMBER |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | CINDY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | JACKSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LCSW |
| Authorized Official - Phone: | 702-268-9977 |
| Mailing Address - Street 1: | 732 S 6TH ST # 4942 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LAS VEGAS |
| Mailing Address - State: | NV |
| Mailing Address - Zip Code: | 89101-6948 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 702-268-9977 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 732 S 6TH ST # 4942 |
| Practice Address - Street 2: | |
| Practice Address - City: | LAS VEGAS |
| Practice Address - State: | NV |
| Practice Address - Zip Code: | 89101-6948 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 702-268-9977 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-05-02 |
| Last Update Date: | 2025-05-02 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health | |
| No | 261QC1800X | Ambulatory Health Care Facilities | Clinic/Center | Corporate Health | |
| No | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | |
| No | 251V00000X | Agencies | Voluntary or Charitable | ||
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 261QM1100X | Ambulatory Health Care Facilities | Clinic/Center | Military/U.S. Coast Guard Outpatient | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
