Provider Demographics
NPI:1093418923
Name:KEILMAN, JAMES ALLEN JR (LSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:KEILMAN
Suffix:JR
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JOHNSTOWN CBOC
Mailing Address - Street 2:598 GALLERIA DR
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904
Mailing Address - Country:US
Mailing Address - Phone:814-943-8164
Mailing Address - Fax:814-266-9382
Practice Address - Street 1:JOHNSTOWN CBOC
Practice Address - Street 2:598 GALLERIA DR
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904
Practice Address - Country:US
Practice Address - Phone:814-943-8164
Practice Address - Fax:814-266-9382
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136104104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker