Provider Demographics
NPI:1487038691
Name:MESSER, KEITH EUGENE (MSW)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:EUGENE
Last Name:MESSER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SUGARTREE COURT
Mailing Address - Street 2:
Mailing Address - City:JOELTON
Mailing Address - State:TN
Mailing Address - Zip Code:37080
Mailing Address - Country:US
Mailing Address - Phone:615-495-8959
Mailing Address - Fax:
Practice Address - Street 1:104 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1101
Practice Address - Country:US
Practice Address - Phone:615-495-8959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical