Provider Demographics
NPI:1427542406
Name:NORTHERN NEVADA CENTER FOR BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:NORTHERN NEVADA CENTER FOR BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D, LBA
Authorized Official - Phone:775-335-6953
Mailing Address - Street 1:2411 EMBLEM ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-9171
Mailing Address - Country:US
Mailing Address - Phone:775-335-6952
Mailing Address - Fax:
Practice Address - Street 1:2411 EMBLEM ST
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-9171
Practice Address - Country:US
Practice Address - Phone:775-335-6953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-03-1439103K00000X
106E00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0015OtherBOARD OF PSYCHOLOGICAL EXAMINERS - NEVADA
1-03-1439OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD