MEDICARE: CLINICAL BEHAVIORAL ASSOCIATES

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	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1134069909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL BEHAVIORAL ASSOCIATES

Provider Business Mailing Address
First Line	:	3430 E FLAMINGO RD STE 217
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5096
Country	:	US
Telephone Number	:	725-249-3531
Fax Number	:

Provider Business Practice Location Address
First Line	:	3430 E FLAMINGO RD STE 217
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5096
Country	:	US
Telephone Number	:	725-249-3531
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	KYALA H HERRING
Credential	:
Telephone Number	:	725-249-3531

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	03/31/2026

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