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NPI Code Detail

MEDICARE: MR. JUSTIN N KYRIANNIS M.A., BCBA,LBA, LMHC

MEDICARE: MR. JUSTIN N KYRIANNIS M.A., BCBA,LBA, LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystLBA143NY
2103K00000XBehavior AnalystBCBA 1-02-0938TN
3103K00000XBehavior AnalystLBA0029NV

General Provider Information

NPI Number : 1760678783
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JUSTIN N KYRIANNIS M.A., BCBA,LBA, LMHC
Provider Business Mailing Address
First Line : 9167 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-6472
Country : US
Telephone Number : 702-565-1894
Fax Number : 702-565-0056
Provider Business Practice Location Address
First Line : 9167 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147
Country : US
Telephone Number : 702-565-1894
Fax Number : 702-565-0056
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2007
Last Update Date : 08/22/2018

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