Cleavon Steve Dyson Jr.

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

CHW1-6212 Issued in NV

Practice address

8879 W Flamingo Rd
Las Vegas, NV 89147-8755

Phone

(702) 213-0007

NPI assigned

Jul 8, 2011

Sex

Male

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.

• Kingdom Behavioral Health, Inc

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1114259355
  NPD (past)

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1811284953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 CURLEW DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891227595",
            "telephone_number": "702-497-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8879 W FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478755",
            "telephone_number": "702-213-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYSON",
        "first_name": "CLEAVON",
        "middle_name": "STEVE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": "NV",
            "license": "CHW1-6212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynasty Surgical Systems, LLC
• Nnekia Dynes
• Mary Dynis, COTA
• Alicia Dyson
• Christopher Evan Dyson
• Gwendolyn Dyson
• James Dyson, COUNSLER
• Kendra Dyson
• Rosalind Dyson
• Shardi D Dyson

• Community Health Worker in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community Health Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.