Healthcare Provider Details

I. General information

NPI: 1538461934
Provider Name (Legal Business Name): KENNETH MCKAY LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N RAINBOW BLVD STE 170
LAS VEGAS NV
89107-1189
US

IV. Provider business mailing address

800 N RAINBOW BLVD STE 170
LAS VEGAS NV
89107-1189
US

V. Phone/Fax

Practice location:
  • Phone: 888-222-1439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0522
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY0522
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPY0522
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPY0522
License Number StateNV

VIII. Authorized Official

Name: KENNETH MCKAY
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 702-419-8920