Provider Demographics
NPI:1417540717
Name:SUSAN KEENE COUNSELING
Entity Type:Organization
Organization Name:SUSAN KEENE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:206-316-0418
Mailing Address - Street 1:12858 22ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98168-2927
Mailing Address - Country:US
Mailing Address - Phone:206-316-0418
Mailing Address - Fax:
Practice Address - Street 1:12858 22ND AVE S
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98168-2927
Practice Address - Country:US
Practice Address - Phone:206-316-0418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health