Provider Demographics
NPI:1003051509
Name:THANEPOHN, HEATHER (LCSW)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:THANEPOHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:STIAWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:500 N CASINO CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-2944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 N CASINO CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-2944
Practice Address - Country:US
Practice Address - Phone:702-383-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5419-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical