Active NPI
Mikaelian McCoy
- Behavior Analyst
- N Las Vegas, NV
National Provider Identifier
1154742807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1404064724
- Practice address
- 1224 Rainy Sky Ave
N Las Vegas, NV 89030-3710 - Phone
- (702) 927-4075
- NPI assigned
- Dec 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 1404064724 | NV | Primary |
Addresses
Primary practice location
1224 Rainy Sky Ave
N Las Vegas, NV 89030-3710
Mailing address
1224 Rainy Sky Ave
N Las Vegas, NV 89030-3710
Phone (702) 927-4075
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1404064724 | NV | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387929600000",
"number": "1154742807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 RAINY SKY AVE",
"city": "N LAS VEGAS",
"state": "NV",
"postal_code": "890303710",
"telephone_number": "702-927-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 RAINY SKY AVE",
"city": "N LAS VEGAS",
"state": "NV",
"postal_code": "890303710",
"telephone_number": "702-927-4075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOY",
"first_name": "MIKAELIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-25",
"last_updated": "2013-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "1404064724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in N Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.