Healthcare Provider Details

I. General information

NPI: 1750873410
Provider Name (Legal Business Name): KAMESHIA COOPER LCPC, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 W TROPICANA AVE
LAS VEGAS NV
89103-4754
US

IV. Provider business mailing address

8390 W WINDMILL LN STE 102&103
LAS VEGAS NV
89113-4420
US

V. Phone/Fax

Practice location:
  • Phone: 702-209-0370
  • Fax:
Mailing address:
  • Phone: 702-888-1340
  • Fax: 702-888-1342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCP5365
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: