Marc Alan Tedoff, PH.D., BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

LBA0005 Issued in NV

Practice address

408 S Jones Blvd
Las Vegas, NV 89107-2658

Phone

(702) 502-8021

NPI assigned

Apr 19, 2011

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Philosophy

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.

• The Institute for Applied Behavior Analysis

  • Adolescent and Children Mental Health Clinic/Center
  • Boca Raton, FL
  • NPI 1417532417
  NPD Authorized official
• Applied Behavior Analysis Institute, Inc.

  • Developmental Disabilities Clinic/Center
  • Las Vegas, NV
  • NPI 1366730434
  NPD (past) Authorized official

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1487945812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072658",
            "telephone_number": "702-502-8021",
            "fax_number": "888-688-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072658",
            "telephone_number": "702-502-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDOFF",
        "first_name": "MARC",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "LBA0005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Tedeschi, NVMT
• Joseph Walter Tedeschi
• Joanna Tedesco
• Tracey Jo Tedesco
• Chloe Tedoff
• Valeria Tedoff
• Yohanna Tedros
• Megan Michelle Tedrow
• Louis Teel
• Tiffany Ann Teepen, PA-C

• 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 Oct 5, 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.