Provider Demographics
NPI:1609506146
Name:ALLEN, KEEGAN RAE MORGAN (LMSW, CSWI)
Entity Type:Individual
Prefix:
First Name:KEEGAN
Middle Name:RAE MORGAN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LMSW, CSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6490 S MCCARRAN BLVD STE A6
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6119
Mailing Address - Country:US
Mailing Address - Phone:775-448-9760
Mailing Address - Fax:
Practice Address - Street 1:6490 S MCCARRAN BLVD BLDG A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6165
Practice Address - Country:US
Practice Address - Phone:775-448-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10027-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV10027-MOtherALL INSURANCE