Individual provider Active NPI

Kathryn Leigh Mahan

  • Behavior Analyst
  • North Las Vegas, NV
National Provider Identifier
1063621779
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0103 Issued in NV
Practice address
3850 W Ann Rd Ste 120
North Las Vegas, NV 89031-4407
Phone
(702) 323-6555
Fax
(702) 323-6613
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA0103 NV Primary

Addresses

Primary practice location

3850 W Ann Rd Ste 120
North Las Vegas, NV 89031-4407

Mailing address

21600 Oxnard St
Suite 1800
Woodland Hills, CA 91367-4976
Phone (818) 345-2345

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

State licenses

LicenseStateTypeSpecialty
LBA0103NVMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1063621779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST",
            "address_2": "SUITE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913674976",
            "telephone_number": "818-345-2345",
            "fax_number": "818-758-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 W ANN RD STE 120",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890314407",
            "telephone_number": "702-323-6555",
            "fax_number": "702-323-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "KATHRYN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "LBA0103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.