Provider Demographics
NPI:1225199672
Name:KEYCARE THERAPIES, INC.
Entity Type:Organization
Organization Name:KEYCARE THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSP, CCC-SLP
Authorized Official - Phone:919-960-9306
Mailing Address - Street 1:129 WOLFS CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9379
Mailing Address - Country:US
Mailing Address - Phone:919-960-9306
Mailing Address - Fax:919-960-9306
Practice Address - Street 1:129 WOLFS CT
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9379
Practice Address - Country:US
Practice Address - Phone:919-960-9306
Practice Address - Fax:919-960-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211618Medicaid
NC7412208Medicaid
NC7211618Medicaid