Makayla Rae Terelak

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CI5463 Issued in NV

Practice address

695 Sierra Rose Dr
Reno, NV 89511-2060

Phone

(775) 453-4143

NPI assigned

Sep 10, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Edwards and Von Ravensberg, Prof. LLC

  dba Great Basin Behavioral Health and Wellness

  • Community/Behavioral Health Agency
  • Reno, NV
  • NPI 1508279746
  NPD (past)

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1417783069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 SIERRA ROSE DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-453-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 SIERRA ROSE DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895112060",
            "telephone_number": "775-453-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERELAK",
        "first_name": "MAKAYLA",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI5463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea C. Tennis
• Mia Love Tennis
• Tommy Tennis
• Heather Teran, BCBA, LBA
• Kaile M Teran
• Marc Avery Terrell, M.ED.
• Terry Key MD LTD
• Terry L. McCaskill M.D. PC
• Haley Terry
• Richard Terry

• Professional Counselor in Reno, NV
• Providers in Reno, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.