MIKAELA KURIN CLARK (NPI# 1902307242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902307242 |
| Entity Type | Individual |
| Full Name | MIKAELA KURIN CLARK |
| Credential | PSY |
| Practice Address |
2110 Los Feliz St Unit 2072 Las Vegas NV 89156-8026 |
| Mailing Address |
5057 Gable Crest Ct Las Vegas NV 89141-3880 |
| Practice Telephone | 7028089204 |
| Mailing Telephone | 8083427392 |
| Mailing Fax Number | 7029920326 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | NV | Behavioral Health & Social Service Providers | |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | NV | Student, Health Care | |
| N | 103K00000X | Behavioral Analyst | NV | Behavioral Health & Social Service Providers |
| Street Address |
2110 LOS FELIZ ST UNIT 2072 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89156-8026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194204396 | Cesar Bermejo | Behavioral Analyst | 2110 Los Feliz St Unit 2072, Las Vegas, NV 89156-8026 | 2018-08-08 |
| 1982195681 | Jessica Henderson | Behavioral Analyst | 2110 Los Feliz St Unit 2072, Las Vegas, NV 89156-8026 | 2018-05-29 |
| 1487143301 | Tanesha Watkins | Behavioral Analyst | 2110 Los Feliz St Unit 2072, Las Vegas, NV 89156-8026 | 2018-05-07 |
| 1467941252 | Jontau White | Behavioral Analyst | 2110 Los Feliz St Unit 2072, Las Vegas, NV 89156-8026 | 2018-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811478712 | Malaika Tamu Hadley Jaffe | Community Based Residential Treatment Facility, Mental Illness | 6644 Jordan River Dr, Las Vegas, NV 89156 | 2018-08-28 |
| 1760908719 | Together We Stand Behavioral Health | Behavioral Analyst | 2110 N Los Feliz St #2072, Las Vegas, NV 89156 | 2017-08-21 |
| 1720356736 | Lucia Carol Matthew | Counselor | 730 N Eastern Avenue, Suite 110, Family Guidance and Wellness Network, Las Vegas, NV 89156 | 2011-12-05 |
| 1033410261 | Henry Sylvester Ebron IIi | Rehabilitation Practitioner | 2110 Los Feliz St, 2083, Las Vegas, NV 89156 | 2010-11-04 |
| 1801196878 | Regina Jackson | Rehabilitation Practitioner | 5254 Paradise Skies Avenue, Las Vegas, NV 89156 | 2010-10-25 |
| 1780830828 | Chris Elaine L Mariano | Registered Nurse | 1972 Napoleon Dr, Las Vegas, NV 89156 | 2008-08-08 |
| 1114320983 | A Omega Dental, LLC | Dentist | 6775 E Lake Mead Blvd, Ste # B9 & B10, Las Vegas, NV 89156 | 2014-10-07 |
| 1437404233 | Christina Maynard | Rehabilitation Practitioner | 2065 Scanlon Ferry Ct Unit 103, Las Vegas, NV 89156-0122 | 2012-07-17 |
| 1851769236 | Michael Spiegelhauer | Behavioral Analyst | 6168 Bluehill Ave Unit 2, Las Vegas, NV 89156-0204 | 2015-09-02 |
| 1760036032 | Mario Henderson | Technician | 5450 E. Lake Mead Blvd, Building D Apt. 225, Las Vegas, NV 89156-0908 | 2019-07-25 |
| Find all providers in zip 89156 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851906440 | David Hernandez | Student in an Organized Health Care Education/Training Program | 1510 Grape Arbor Way, Las Vegas, NV 89142-0669 | 2020-09-10 |
| 1710591110 | Jessica Celestino | Student in an Organized Health Care Education/Training Program | 6167 Allen Cove Ct, Las Vegas, NV 89148-1799 | 2020-09-02 |
| 1972127314 | Toyokazu Endo | Student in an Organized Health Care Education/Training Program | 2040 W Charleston Blvd Fl 3, Las Vegas, NV 89102-2227 | 2020-06-01 |
| 1962025775 | William Taylor Gravley | Student in an Organized Health Care Education/Training Program | 1510 Ruby Cliffs Ln Unit 204, Las Vegas, NV 89144-7015 | 2020-05-27 |
| 1477174449 | Vishnu Halthore | Student in an Organized Health Care Education/Training Program | 2152 Turquoise Ridge St Unit 205, Las Vegas, NV 89117-5972 | 2020-05-01 |
| 1417576869 | Jesus Mendez Jr. | Student in an Organized Health Care Education/Training Program | 10962 Pentland Downs St, Las Vegas, NV 89141-3997 | 2020-04-15 |
| 1124657333 | Daniel Gerardo Arias | Student in an Organized Health Care Education/Training Program | 700 Shadow Ln Ste 400, Las Vegas, NV 89106-4159 | 2020-04-08 |
| 1659900959 | Connor Wayman | Student in an Organized Health Care Education/Training Program | 6655 S Cimarron Rd, Las Vegas, NV 89113-2180 | 2020-04-07 |
| 1700413887 | Sameera Baig | Student in an Organized Health Care Education/Training Program | 2880 N. Tenaya Way, Las Vegas, NV 89128-0431 | 2020-03-26 |
| 1457988537 | Wesley Washington Yim | Student in an Organized Health Care Education/Training Program | 657 N Town Center Dr Ofc, Las Vegas, NV 89144-6367 | 2020-03-26 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.