MEDICARE: LASHUNDORA MCKINNEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	101YP2500X	Professional Counselor
3	251S00000X	Community/Behavioral Health Agency
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1497291082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHUNDORA MCKINNEY

Provider Business Mailing Address
First Line	:	520 COLLEGE DR APT 926
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-7586
Country	:	US
Telephone Number	:	702-715-9881
Fax Number	:

Provider Business Practice Location Address
First Line	:	4660 S EASTERN AVE STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6139
Country	:	US
Telephone Number	:	702-478-8205
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	10/04/2017

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Directions to “ LASHUNDORA MCKINNEY ” Practice Location

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