Individual provider Active NPI

Matthew Maanao

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1508441213
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MI4499 Issued in NV
Practice address
6600 W Charleston Blvd Ste 111
Las Vegas, NV 89146-1067
Phone
(702) 283-6215
Fax
(702) 979-1028
NPI assigned
Mar 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MI4499 NV Primary
Behavior Technician 106S00000X NV
Rehabilitation Practitioner 225400000X NV

Addresses

Primary practice location

6600 W Charleston Blvd Ste 111
Las Vegas, NV 89146-1067

Mailing address

5575 Simmons St Ste 1-491
North Las Vegas, NV 89031-9009
Phone (702) 283-6215

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
MI4499NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Autism & Behavioral Consulting Services CurrentSince May 8, 2022 Accepting new patients
Autism & Behavioral Consulting Services Behavior Technician CurrentSince Mar 21, 2021 Accepting new patients

Locations

5575 Simmons St
Ste 1491
North Las Vegas, NV 89031
Phone (702) 283-6215

Organizations & group practices 2

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1508441213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 SIMMONS ST STE 1-491",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890319009",
            "telephone_number": "702-283-6215",
            "fax_number": "702-979-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W CHARLESTON BLVD STE 111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461067",
            "telephone_number": "702-283-6215",
            "fax_number": "702-979-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAANAO",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "MI4499",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NV",
            "license": null,
            "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 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.