MEDICARE: STRIDE BEHAVIORAL HEALTH PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1750115804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRIDE BEHAVIORAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	6855 W CHARLESTON BLVD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1675
Country	:	US
Telephone Number	:	725-205-3557
Fax Number	:	725-228-8875

Provider Business Practice Location Address
First Line	:	6855 W CHARLESTON BLVD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1675
Country	:	US
Telephone Number	:	614-230-6081
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	SHAILENDRA KUMAR JAIN
Credential	:	PMHNP,FNP
Telephone Number	:	725-205-3557

Provider Enumeration Date	:	08/30/2024
Last Update Date	:	04/29/2025

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