Healthcare Provider Details

I. General information

NPI: 1346162146
Provider Name (Legal Business Name): SHANERICA ELISE HANKENS CPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S RANCHO DR STE A10
LAS VEGAS NV
89106-4898
US

IV. Provider business mailing address

7785 LOVELY SQUAW CT
LAS VEGAS NV
89179-2059
US

V. Phone/Fax

Practice location:
  • Phone: 702-809-3507
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCI5728
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: