Provider Demographics
NPI:1871867820
Name:MCKINNEY, ALESE (MS, LADC, LCADC)
Entity Type:Individual
Prefix:
First Name:ALESE
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MS, LADC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 E DESERT INN RD STE 180
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3627
Mailing Address - Country:US
Mailing Address - Phone:702-252-8342
Mailing Address - Fax:
Practice Address - Street 1:2725 E DESERT INN RD STE 180
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3627
Practice Address - Country:US
Practice Address - Phone:702-252-8342
Practice Address - Fax:702-252-8349
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00314-LC101YM0800X
NV01311-L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)