Healthcare Provider Details

I. General information

NPI: 1063306223
Provider Name (Legal Business Name): PINYON BEHAVIORAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 E MARION RUSSELL DR
GARDNERVILLE NV
89410-5825
US

IV. Provider business mailing address

1337 E MARION RUSSELL DR
GARDNERVILLE NV
89410-5825
US

V. Phone/Fax

Practice location:
  • Phone: 775-234-8543
  • Fax:
Mailing address:
  • Phone: 775-234-8543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT VERNON PAGE
Title or Position: CO-FOUNDER/CEO
Credential: PHD, BCBA-D
Phone: 775-234-8543