Provider Demographics
NPI:1417485137
Name:KEEL, LYNN MATTI (LPCC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MATTI
Last Name:KEEL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 BARBERRY LN
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4295
Mailing Address - Country:US
Mailing Address - Phone:715-574-4584
Mailing Address - Fax:715-574-4584
Practice Address - Street 1:325 BARBERRY LN
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4295
Practice Address - Country:US
Practice Address - Phone:715-574-4584
Practice Address - Fax:715-574-4584
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional