Provider Demographics
NPI:1750873410
Name:COOPER, KAMESHIA (LCPC, LCADC)
Entity type:Individual
Prefix:
First Name:KAMESHIA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:LCPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 W TROPICANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4754
Mailing Address - Country:US
Mailing Address - Phone:702-209-0370
Mailing Address - Fax:
Practice Address - Street 1:6767 W TROPICANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4754
Practice Address - Country:US
Practice Address - Phone:702-209-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP5365101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional