Provider Demographics
NPI:1184182875
Name:PARTIDA, STEPHANIE (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:PARTIDA
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7868 WILD THISTLE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-1632
Mailing Address - Country:US
Mailing Address - Phone:760-937-0118
Mailing Address - Fax:702-272-2011
Practice Address - Street 1:7868 WILD THISTLE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-1632
Practice Address - Country:US
Practice Address - Phone:760-937-0118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV07114-LC101YA0400X
104100000X
NV9192-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1184182875Medicaid