Active NPI
Kylie Tahakjian, M.A.
- Behavior Analyst
- Phoenix, AZ
National Provider Identifier
1013763002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BEH-002204
- Practice address
- 11201 N Tatum Blvd Ste 100
Phoenix, AZ 85028-6037 - Phone
- (623) 263-3966
- NPI assigned
- Apr 29, 2024
- Last updated
- Aug 25, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BEH-002204 | AZ | Primary |
Addresses
Primary practice location
11201 N Tatum Blvd Ste 100
Phoenix, AZ 85028-6037
Mailing address
11201 N Tatum Blvd Ste 100
Phoenix, AZ 85028-6037
Phone (623) 263-3966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BEH-002204 | AZ | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soar Health, Inc. | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1013763002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11201 N TATUM BLVD STE 100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286037",
"telephone_number": "623-263-3966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 N TATUM BLVD STE 100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850286037",
"telephone_number": "623-263-3966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAHAKJIAN",
"first_name": "KYLIE",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-29",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "BEH-002204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.