Provider Demographics
NPI:1730518606
Name:TATE, KEENA (LCPC, LMHC, NCC)
Entity type:Individual
Prefix:
First Name:KEENA
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:LCPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E REGENA AVE UNIT 235
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3665
Mailing Address - Country:US
Mailing Address - Phone:702-352-6008
Mailing Address - Fax:
Practice Address - Street 1:1640 E FLAMINGO RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5280
Practice Address - Country:US
Practice Address - Phone:702-498-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61553975101YM0800X
NVCP5544101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health