Mikayla Alexandra Camacho, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-75956 Issued in UT

Practice address

429 S Main St
Logan, UT 84321-5207

Phone

(801) 683-1062

NPI assigned

Aug 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Neurobehavioral Center for Growth LLC

  • Psychologist
  • Bountiful, UT
  • NPI 1942641931
  NPD (past)

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1669148409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 N 230 W",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412255",
            "telephone_number": "678-637-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 S MAIN ST",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215207",
            "telephone_number": "801-683-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "MIKAYLA",
        "middle_name": "ALEXANDRA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-24-352746",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "1-24-75956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "568946544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "5874",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanna Lee Call
• Hollie Kay Callaway, PHD
• Michael S Callister, M.D.
• Marcia Diane Calloway-Graham, PHD
• James Calvimonte
• Blake S Cameron, DDS
• Courtney Campbell
• Mackenzie Campbell
• Todd Campbell
• Campus Academy

• All providers in Logan, UT
• Behavior Analyst in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.