Individual provider Active NPI

Joel Mishalow, PHD

  • Clinical Psychologist
  • Las Vegas, NV
National Provider Identifier
1003984774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PYO344 Issued in NV
Practice address
6000 West Rochelle Ave
#300
Las Vegas, NV 89103
Phone
(702) 252-3535
Fax
(702) 362-1357
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PYO344 NV Primary

Addresses

Primary practice location

6000 West Rochelle Ave
#300
Las Vegas, NV 89103

Mailing address

6000 West Rochelle Ave
#300
Las Vegas, NV 89103
Phone (702) 252-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2016 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PYO344NVMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003984774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 WEST ROCHELLE AVE",
            "address_2": "#300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89103",
            "telephone_number": "702-252-3535",
            "fax_number": "702-362-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 WEST ROCHELLE AVE",
            "address_2": "#300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89103",
            "telephone_number": "702-252-3535",
            "fax_number": "702-362-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHALOW",
        "first_name": "JOEL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PYO344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.