Individual provider Active NPI

Tiyesha Crowe-Gonzales

  • Behavior Technician
  • Las Vegas, NV
National Provider Identifier
1639907199
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT4428 Issued in NV
Practice address
5803 W Craig Rd Ste 105
Las Vegas, NV 89130-2537
Phone
(702) 901-5200
NPI assigned
Jul 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT4428 NV Primary

Addresses

Primary practice location

5803 W Craig Rd Ste 105
Las Vegas, NV 89130-2537

Mailing address

1698 S Christy LN
Las Vegas, NV 89142-1179
Phone (702) 859-2351

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
RBT4428NVMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1639907199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 S CHRISTY LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891421179",
            "telephone_number": "702-859-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 W CRAIG RD STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891302537",
            "telephone_number": "702-901-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWE-GONZALES",
        "first_name": "TIYESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": "RBT4428",
            "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 Jul 24, 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.