Provider Demographics
NPI:1740787688
Name:GUINN, KEITH C (LMSW, CSW-I)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:C
Last Name:GUINN
Suffix:
Gender:M
Credentials:LMSW, CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 SKY POINTE DR APT 2140
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4968
Mailing Address - Country:US
Mailing Address - Phone:702-812-0588
Mailing Address - Fax:
Practice Address - Street 1:720 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3614
Practice Address - Country:US
Practice Address - Phone:702-331-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-08
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10675-M104100000X
NVIC-26271041C0700X
NV1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical