Provider Demographics
NPI:1952065872
Name:KEI THERAPY LLC
Entity Type:Organization
Organization Name:KEI THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHERONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-856-1092
Mailing Address - Street 1:5135 CAMINO AL NORTE STE 276
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2420
Mailing Address - Country:US
Mailing Address - Phone:708-856-1092
Mailing Address - Fax:
Practice Address - Street 1:5135 CAMINO AL NORTE STE 276
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2420
Practice Address - Country:US
Practice Address - Phone:708-856-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty