Individual
STACY LEDESMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
552 E CHARLESTON BLVD, LAS VEGAS, NV 89104-1319
(702) 440-8440
(866) 518-0781
Mailing address
840 S RANCHO DR STE 4-337, LAS VEGAS, NV 89106-3837
(702) 440-8840
(866) 518-0781
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00324-C
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
07225-S
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235633421
COMMERCIAL
NV
Enumeration date
02/23/2023
Last updated
02/23/2023
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