Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lieutenant Johnson Superville, PHD

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1790458156

Lieutenant Johnson Superville, PHD is a Psychiatry in Henderson, Nevada. Graduated from Nova Southeastern College of Osteo Medicine in 2019, 7 years ago. Licensed in Nevada.

Years since qualifying
7
Trained at
Nova Southeastern College of Osteo Medicine
Licensed in
NV
In the registry since
2021
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

6301 Mountain Vista St Ste 104
Henderson, NV 89014-2365
Phone: (512) 201-6766
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 847157 (NV)

Record details

NPI number1790458156
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedJuly 30, 2021
Last updated in NPPESDecember 5, 2025
Certification dateDecember 5, 2025
Mailing address6301 Mountain Vista St Ste 104, Henderson, NV 89014-2365

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolNOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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