Individual provider Active NPI

Therese Stanke

  • Addiction (Substance Use Disorder) Counselor
  • Las Vegas, NV
National Provider Identifier
1053204115
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
07042-1 Issued in NV
Practice address
916 N Main St
Las Vegas, NV 89101-1931
Phone
(702) 202-6647
NPI assigned
May 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 07042-1 NV Primary

Addresses

Primary practice location

916 N Main St
Las Vegas, NV 89101-1931

Mailing address

11319 La Madre Ridge Dr
Las Vegas, NV 89135-1829
Phone (702) 528-7328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
07042-1NVMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vegas Stronger Ccbhc CurrentSince Jun 3, 2025 Accepting new patients

Locations

916 N Main St
Las Vegas, NV 89101
Phone (702) 202-6647

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1053204115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11319 LA MADRE RIDGE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351829",
            "telephone_number": "702-528-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 N MAIN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891011931",
            "telephone_number": "702-202-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKE",
        "first_name": "THERESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07042-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.