Organization Active NPI

Marilyn Strada PHD LLC

  • Clinical Neuropsychologist
  • Las Vegas, NV
National Provider Identifier
1417456005
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PYO811 Issued in NV
Legal business name
MARILYN STRADA PHD LLC
Practice address
8565 S Eastern Ave Ste 152
Las Vegas, NV 89123-2906
Phone
(562) 274-8203
Fax
(562) 478-4575
NPI assigned
Feb 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Dr. Marilyn Strada, PHDNPI 1992840789
Title
Psychologist
Phone
(702) 635-6555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103G00000X PYO811 NV Primary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X PYO811 NV
Cognitive & Behavioral PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TB0200X PYO811 NV

Addresses

Primary practice location

8565 S Eastern Ave Ste 152
Las Vegas, NV 89123-2906

Mailing address

8565 S Eastern Ave Ste 152
Las Vegas, NV 89123-2906
Phone (702) 635-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180320003162 NV Part B Supplier - Clinic/Group Practice 1658633102 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

8565 S Eastern Ave
Ste 152
Las Vegas, NV 89123
Phone (562) 274-8203

8565 S Eastern Ave
Ste 106
Las Vegas, NV 89123

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1417456005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8565 S EASTERN AVE STE 152",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232906",
            "telephone_number": "702-635-6555",
            "fax_number": "562-478-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8565 S EASTERN AVE STE 152",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891232906",
            "telephone_number": "562-274-8203",
            "fax_number": "562-478-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN STRADA PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "STRADA",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "702-635-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NV",
            "license": "PYO811",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PYO811",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NV",
            "license": "PYO811",
            "primary": false
        }
    ],
    "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 Apr 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.