Provider Demographics
NPI:1093165110
Name:KEYS, ARIAN D (CSW)
Entity Type:Individual
Prefix:MR
First Name:ARIAN
Middle Name:D
Last Name:KEYS
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:MR
Other - First Name:ARIAN
Other - Middle Name:D
Other - Last Name:KEYS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CSW
Mailing Address - Street 1:48297 WALTRIP LN
Mailing Address - Street 2:
Mailing Address - City:TICKFAW
Mailing Address - State:LA
Mailing Address - Zip Code:70466-3624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 SASSAFRAS ST
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-3425
Practice Address - Country:US
Practice Address - Phone:985-247-2838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12056101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health