Basic Information
| Provider Information | |||||||||
| NPI: | 1871867820 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCKINNEY | ||||||||
| FirstName: | ALESE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MS, LADC, LCADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2725 E DESERT INN RD STE 180 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891213627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022528342 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2725 E DESERT INN RD STE 180 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891213627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022528342 | ||||||||
| FaxNumber: | 7022528349 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2012 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 00314-LC | NV | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YA0400X | 01311-L | NV | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.