Individual provider Active NPI

Allan Mamaclay

  • Behavior Analyst
  • Las Vegas, NV
National Provider Identifier
1396410197
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0548 Issued in NV
Practice address
2700 Chandler Ave BLDG B
Las Vegas, NV 89120-4028
Phone
(702) 703-0144
NPI assigned
Aug 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X LBA0548 NV Primary

Addresses

Primary practice location

2700 Chandler Ave BLDG B
Las Vegas, NV 89120-4028

Mailing address

2700 Chandler Ave BLDG B
Las Vegas, NV 89120-4028
Phone (702) 703-0144

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

LicenseStateTypeSpecialty
LBA0548NVMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Achievable Behavior Strategies Behavior Analyst PastSince Aug 1, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1396410197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 CHANDLER AVE BLDG B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891204028",
            "telephone_number": "702-703-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 CHANDLER AVE BLDG B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891204028",
            "telephone_number": "702-703-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMACLAY",
        "first_name": "ALLAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-12",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "LBA0548",
            "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 Jan 31, 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.