Individual
DR. KEITH ANTHONY FAIRCLOUGH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC, CPC, ACS
Contact information
Practice address
1300 S JONES BLVD STE 250, LAS VEGAS, NV 89146-1210
(561) 309-3507
(702) 975-1022
Mailing address
9224 TUDOR PARK PL, LAS VEGAS, NV 89145-8726
(561) 309-3507
(702) 975-1022
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CP3002-R
NV
101YM0800X
Mental Health Counselor
Primary
IMH12852
FL
101YM0800X
Mental Health Counselor
MH15958
FL
Other
Enumeration date
11/25/2015
Last updated
01/27/2026
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