Provider Demographics
NPI:1508174277
Name:KELLER, SCOTT SANDS (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:SANDS
Last Name:KELLER
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-8757
Mailing Address - Country:US
Mailing Address - Phone:717-250-4682
Mailing Address - Fax:
Practice Address - Street 1:12814 HAMPTON HILL DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7558
Practice Address - Country:US
Practice Address - Phone:813-545-8829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 95011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical