Provider Demographics
NPI:1164608220
Name:KEEFER, MICHAEL ALEXANDER (LPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALEXANDER
Last Name:KEEFER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4099 FOXWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5222
Mailing Address - Country:US
Mailing Address - Phone:757-467-8184
Mailing Address - Fax:757-467-2485
Practice Address - Street 1:4099 FOXWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5222
Practice Address - Country:US
Practice Address - Phone:757-467-8184
Practice Address - Fax:757-467-2485
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional