Provider Demographics
NPI:1588097570
Name:PINEDA, STEPHANIE MICHELLE (LMFT, LCADC-INTERN)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:PINEDA
Suffix:
Gender:F
Credentials:LMFT, LCADC-INTERN
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:MICHELLE
Other - Last Name:HANGEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT, LCADC-INTERN
Mailing Address - Street 1:526 S TONOPAH DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4013
Mailing Address - Country:US
Mailing Address - Phone:702-440-8440
Mailing Address - Fax:
Practice Address - Street 1:526 S TONOPAH DR STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4013
Practice Address - Country:US
Practice Address - Phone:702-440-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00328101YA0400X
NV2674106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)