Healthcare Provider Details
I. General information
NPI: 1134069909
Provider Name (Legal Business Name): CLINICAL BEHAVIORAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3430 E FLAMINGO RD STE 217
LAS VEGAS NV
89121-5096
US
IV. Provider business mailing address
3430 E FLAMINGO RD STE 217
LAS VEGAS NV
89121-5096
US
V. Phone/Fax
- Phone: 725-249-3531
- Fax:
- Phone: 725-249-3531
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084B0040X |
| Taxonomy | Behavioral Neurology & Neuropsychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KYALA
H
HERRING
Title or Position: MANAGING MEMBER
Credential:
Phone: 725-249-3531