Stephanie Reisdorf, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

STEPHANIE REISDORF, LLC

Practice address

701 N Pecos Rd BLDG K-1
Las Vegas, NV 89101-2400

Phone

(702) 289-8435

NPI assigned

Mar 29, 2023

Organization subpart

No

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

Authorized official

Name

Stephanie Reisdorf, LCSWNPI 1831526888

Title

Owner

Phone

(702) 289-8435

Specialties & licenses 1

Addresses

Other names 1

• Sunrise Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Reisdorf

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1831526888
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1831893239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 VILLA DE CONDE WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022013",
            "telephone_number": "702-289-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N PECOS RD BLDG K-1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891012400",
            "telephone_number": "702-289-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE REISDORF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "REISDORF",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-289-8435",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie a Wishnev MD LTD
• Stephanie Batista DMD PLLC
• Stephanie Hernandez DMD PLLC
• Stephanie J Youngblood DC LTD
• Stephanie Johnson OD, P.C.
• Stephanie Stowman, PHD, PLLC
• Stephen a Gephardt MD LTD
• Stephen Castorino MD PC
• Stephen H Miller MD PC
• Stephen J Chiarello LTD

• Adolescent and Children Mental Health Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Adolescent and Children Mental Health Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.