Individual provider Active NPI

Stephanie Elena Ghanem

  • Behavior Technician
  • Las Vegas, NV
National Provider Identifier
1306402664
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
7390 W Sahara Ave Ste 260
Las Vegas, NV 89117-2765
Phone
(702) 900-4320
Fax
(608) 646-6124
NPI assigned
May 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

7390 W Sahara Ave Ste 260
Las Vegas, NV 89117-2765

Mailing address

7390 W Sahara Ave Ste 260
Las Vegas, NV 89117-2765
Phone (702) 900-4320

Other practice location 1

7310 Smoke Ranch Rd Ste S
Las Vegas, NV 89128-0260
Phone (702) 608-7290

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.simplepractice.com Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Autism Center, LLC Behavior Technician Past Accepting new patients

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": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1306402664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7390 W SAHARA AVE STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172765",
            "telephone_number": "702-900-4320",
            "fax_number": "608-646-6124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7390 W SAHARA AVE STE 260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891172765",
            "telephone_number": "702-900-4320",
            "fax_number": "608-646-6124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7310 Smoke Ranch Rd Ste S",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280260",
            "country_code": "US",
            "telephone_number": "702-608-7290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHANEM",
        "first_name": "STEPHANIE",
        "middle_name": "ELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "Simple Practice",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.calmgardenstherapy.com",
            "address_1": "7473 W Lake Mead Blvd",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891280265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 28, 2023; 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.