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NPI Code Detail

MEDICARE: MS. STEPHANIE MICHELLE PINEDA LMFT, LCADC-INTERN

MEDICARE: MS. STEPHANIE MICHELLE PINEDA LMFT, LCADC-INTERN
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
1101YA0400XAddiction (Substance Use Disorder) Counselor00328NV
2106H00000XMarriage & Family Therapist2674NV

General Provider Information

NPI Number : 1588097570
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE MICHELLE PINEDA LMFT, LCADC-INTERN
Provider Business Mailing Address
First Line : 526 S TONOPAH DR STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4013
Country : US
Telephone Number : 702-440-8440
Fax Number :
Provider Business Practice Location Address
First Line : 526 S TONOPAH DR STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4013
Country : US
Telephone Number : 702-440-8440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2013
Last Update Date : 05/18/2020

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