Provider Demographics
NPI:1114000593
Name:GREER, KEITH STUART (LCSW)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:STUART
Last Name:GREER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PENBROOKE DR
Mailing Address - Street 2:BUILDING 2, SUITE K
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-2041
Mailing Address - Country:US
Mailing Address - Phone:585-377-6470
Mailing Address - Fax:
Practice Address - Street 1:401 PENBROOKE DR
Practice Address - Street 2:BUILDING 2, SUITE K
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2041
Practice Address - Country:US
Practice Address - Phone:585-377-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY359571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical