Active NPI
Brooklyn Wangsgard
- Behavior Analyst
- Las Vegas, NV
National Provider Identifier
1104389717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3130 S Durango Dr Ste 425
Las Vegas, NV 89117-4455 - Phone
- (702) 972-6823
- NPI assigned
- Apr 10, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
3130 S Durango Dr Ste 425
Las Vegas, NV 89117-4455
Mailing address
4620 Pony Express St
North Las Vegas, NV 89031-0115
Phone (801) 505-3783
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1104389717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4620 PONY EXPRESS ST",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890310115",
"telephone_number": "801-505-3783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 S DURANGO DR STE 425",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891174455",
"telephone_number": "702-972-6823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANGSGARD",
"first_name": "BROOKLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-10",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.