Healthcare Provider Details

I. General information

NPI: 1740787688
Provider Name (Legal Business Name): KEITH C GUINN LMSW, CSW-I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 S JONES BLVD
LAS VEGAS NV
89107-3614
US

IV. Provider business mailing address

5850 SKY POINTE DR APT 2140
LAS VEGAS NV
89130-4968
US

V. Phone/Fax

Practice location:
  • Phone: 702-331-4874
  • Fax:
Mailing address:
  • Phone: 702-812-0588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-2627
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10675-M
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: