Provider Demographics
NPI:1083876924
Name:KEE, LISA MARIE (LISW, CADC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:KEE
Suffix:
Gender:F
Credentials:LISW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 E. KANESVILLE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503
Mailing Address - Country:US
Mailing Address - Phone:712-256-9660
Mailing Address - Fax:712-256-9661
Practice Address - Street 1:427 E. KANESVILLE
Practice Address - Street 2:SUITE 102
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:712-256-9660
Practice Address - Fax:712-256-9661
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0070901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical