Individual provider Active NPI

Gustavo Salathiel Reyes Sanchez, LMSW, LADC, CSW-I

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1679217921
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
IC-2617 Issued in NV
Practice address
911 N Buffalo Dr Ste 206213
Las Vegas, NV 89128-0379
Phone
(702) 405-8088
NPI assigned
Apr 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11294-M NV
Addiction (Substance Use Disorder) Counselor 101YA0400X 07940-L NV
Clinical Social Worker 1041C0700X IC-2617 NV Primary

Addresses

Primary practice location

911 N Buffalo Dr Ste 206213
Las Vegas, NV 89128-0379

Mailing address

1940 Soto LN
North Las Vegas, NV 89032-6019
Phone (702) 701-4488

Other practice location 1

2921 N Tenaya Way
Las Vegas, NV 89128-1409
Phone (702) 978-8000

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
07940-LNVMDAddiction (Substance Use Disorder) Counselor
11294-MNVMDSocial Worker
IC-2617NVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Residential Services LLC PastSince Feb 1, 2024 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": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1679217921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 SOTO LN",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890326019",
            "telephone_number": "702-701-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N BUFFALO DR STE 206213",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280379",
            "telephone_number": "702-405-8088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2921 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891281409",
            "country_code": "US",
            "telephone_number": "702-978-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES SANCHEZ",
        "first_name": "GUSTAVO",
        "middle_name": "SALATHIEL",
        "credential": "LMSW, LADC, CSW-I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-22",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "11294-M",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07940-L",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "IC-2617",
            "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 Sep 3, 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.