Healthcare Provider Details

I. General information

NPI: 1184321804
Provider Name (Legal Business Name): RACHEL KEO MA, LMHC, CPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 S MARYLAND PKWY
LAS VEGAS NV
89154-9900
US

IV. Provider business mailing address

4505 S MARYLAND PKWY
LAS VEGAS NV
89154-9900
US

V. Phone/Fax

Practice location:
  • Phone: 702-895-4146
  • Fax:
Mailing address:
  • Phone: 702-895-4146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCP6278-R
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61392996
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: