Michael Kelly Gann, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY26848 Issued in CA

Practice address

1180 N Town Center Dr Ste 100
Las Vegas, NV 89144-6363

Phone

(702) 333-2907

Fax

(702) 333-2693

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1164530812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3862 STARFIELD LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478032",
            "telephone_number": "702-333-2907",
            "fax_number": "702-333-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N TOWN CENTER DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446363",
            "telephone_number": "702-333-2907",
            "fax_number": "702-333-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANN",
        "first_name": "MICHAEL",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NV",
            "license": "PY0791",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3413",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Ganir
• Bryan Reynon Ganitano
• Caroline Ganja
• Patricia Maria Ganja, PA-C
• Sharokina June Ganja
• Joshua Gannon
• Michael Gannon, RN
• Brithany Gano, ATC
• Arlette Ganso, FNP-C
• Coletta Gant

• Clinical Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.