Individual ProviderShaninda PettesCounselorBehavioral Health & Social Service ProvidersPractice Address801 S Rancho Dr Ste C3, Las Vegas, NV 89106-3858(702) 366-1640PECOS EnrollmentBased on the most recent information from CMS, provider Shaninda Pettes does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1194528448Provider TypeIndividualFull NamePettes, ShanindaGenderFemaleSole ProprietorNoEnumeration Date3/31/2025Last Updated3/31/2025Contact InformationPractice LocationPractice Address801 S Rancho Dr Ste C3, Las Vegas, NV 89106-3858Phone(702) 366-1640FaxUnlisted FaxMailing LocationMailing Address801 S Rancho Dr Ste C3, Las Vegas, NV 89106-3858Phone(702) 366-1640FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseCI-5493Nevada