MEDICARE: STEPHANIE THOMAS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	174200000X	Meals Provider
3	253Z00000X	In Home Supportive Care Agency
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1588164354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE THOMAS

Provider Business Mailing Address
First Line	:	3981 WEYBRIDGE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4856
Country	:	US
Telephone Number	:	702-888-2312
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 G ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3313
Country	:	US
Telephone Number	:	702-888-2312
Fax Number	:

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

Provider Enumeration Date	:	02/18/2018
Last Update Date	:	05/31/2019

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Directions to “ STEPHANIE THOMAS ” Practice Location

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