MEDICARE: MS. CONSTANCE KNIGHT KEY MFT, LCADC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	01039	NV

General Provider Information

NPI Number	:	1689715484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CONSTANCE KNIGHT KEY MFT, LCADC

Provider Business Mailing Address
First Line	:	5071 N RAINBOW BLVD
Second Line	:	SUITE #170
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1606
Country	:	US
Telephone Number	:	702-395-4002
Fax Number	:	702-395-4003

Provider Business Practice Location Address
First Line	:	5071 N RAINBOW BLVD
Second Line	:	SUITE #170
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1606
Country	:	US
Telephone Number	:	702-395-4002
Fax Number	:	702-395-4003

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	11/28/2023

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