Individual provider Active NPI

Pe'Shance Reyes, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Reno, NV
National Provider Identifier
1386157212
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
07466-C Issued in NV
Practice address
9498 Double R Blvd Ste a
Reno, NV 89521-2905
Phone
(775) 964-4898
Fax
(866) 356-7299
NPI assigned
Nov 14, 2017
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 07466-C NV Primary
Behavior Technician 106S00000X RBT-17-42739 NV

Addresses

Primary practice location

9498 Double R Blvd Ste a
Reno, NV 89521-2905

Mailing address

2440 Vassar St Ste 3
Reno, NV 89502-3224
Phone (775) 448-6533

Other practice location 1

2440 Vassar St
Reno, NV 89502-3453
Phone (775) 448-6533

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
07466-CNVMDAddiction (Substance Use Disorder) Counselor
RBT-17-42739NVMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
CDT Service Corp. CurrentSince Nov 26, 2023 Accepting new patients

Locations

9498 Double R Blvd
Ste A
Reno, NV 89521
Phone (775) 909-4829

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1386157212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 VASSAR ST STE 3",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895023224",
            "telephone_number": "775-448-6533",
            "fax_number": "775-787-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9498 DOUBLE R BLVD STE A",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895212905",
            "telephone_number": "775-964-4898",
            "fax_number": "866-356-7299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2440 Vassar St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895023453",
            "country_code": "US",
            "telephone_number": "775-448-6533",
            "fax_number": "775-787-2751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "PE'SHANCE",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07466-C",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": "RBT-17-42739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.