Provider Demographics
NPI:1033287388
Name:KEATING, PATRICIA ELAINE (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELAINE
Last Name:KEATING
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 GARRISONVILLE RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-1545
Mailing Address - Country:US
Mailing Address - Phone:540-657-1228
Mailing Address - Fax:540-657-1999
Practice Address - Street 1:385 GARRISONVILLE RD
Practice Address - Street 2:SUITE 113
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1545
Practice Address - Country:US
Practice Address - Phone:540-657-1228
Practice Address - Fax:540-657-1999
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002922101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5409233Medicaid