Individual provider Active NPI

Shakeemia Shameece Anifowoshe

  • Behavior Analyst
  • N Las Vegas, NV
National Provider Identifier
1255811683
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
5552 Mesquite Creek St
N Las Vegas, NV 89031-6835
Phone
(702) 703-9788
NPI assigned
Aug 15, 2018
Last updated
May 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Specialist 174400000X NU
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

5552 Mesquite Creek St
N Las Vegas, NV 89031-6835

Mailing address

4832 Mahogany Dr
Las Vegas, NV 89110-4734
Phone (702) 945-4366

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Wings Wellness Center Behavior Analyst CurrentSince Jun 8, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1255811683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4832 MAHOGANY DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891104734",
            "telephone_number": "702-945-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5552 MESQUITE CREEK ST",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890316835",
            "telephone_number": "702-703-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIFOWOSHE",
        "first_name": "SHAKEEMIA",
        "middle_name": "SHAMEECE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "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 May 23, 2025; 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.