MEDICARE: KAYANA IEISHA-MARIE LEWIS M.S.

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
1	103K00000X	Behavior Analyst	1-20-46192	NV
2	171M00000X	Case Manager/Care Coordinator
3	106S00000X	Behavior Technician	RBT-18-52418	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	RBT-18-52418	OTHER	NV	BEHAVIOR ANALYST CERTIFICATION BOARD
3	1-20-46192	OTHER	NV	BEHAVIOR ANALYST CERTIFICATION BOARD

General Provider Information

NPI Number	:	1770968844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYANA IEISHA-MARIE LEWIS M.S.

Provider Business Mailing Address
First Line	:	3016 W CHARLESTON BLVD STE 205
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1963
Country	:	US
Telephone Number	:	702-780-2315
Fax Number	:	702-895-4014

Provider Business Practice Location Address
First Line	:	630 S RANCHO DR STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4849
Country	:	US
Telephone Number	:	702-998-9505
Fax Number	:	702-527-7939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2015
Last Update Date	:	05/11/2026

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Directions to “ KAYANA IEISHA-MARIE LEWIS M.S.” Practice Location

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