Lauren Rose Mack

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

02112512 Issued in NV

Practice address

5803 W Craig Rd Ste 105
Las Vegas, NV 89130-2537

Phone

(702) 901-5200

Fax

(702) 901-5201

NPI assigned

Aug 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1174002703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11425 DRAPPO AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891386083",
            "telephone_number": "702-576-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 W CRAIG RD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302537",
            "telephone_number": "702-901-5200",
            "fax_number": "702-901-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "LAUREN",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "02112512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Charles Mack Jr.
• I'Asia Mack
• Jeffrey Mack
• John F Mack, D.D.S.
• Kenneth Dawyane Mack
• Princella Mack, LPN
• Samuel Mack
• Shyleice L Mack
• Tajanae Mack
• Terry Mack

• Behavior Analyst in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Analyst in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.