Provider Demographics
NPI:1518002518
Name:HAY, KEISHA S (LICSW, GMHS)
Entity Type:Individual
Prefix:
First Name:KEISHA
Middle Name:S
Last Name:HAY
Suffix:
Gender:F
Credentials:LICSW, GMHS
Other - Prefix:
Other - First Name:KEISHA
Other - Middle Name:S
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW, GMHS
Mailing Address - Street 1:12040 NE 128TH ST # MS -74
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3013
Mailing Address - Country:US
Mailing Address - Phone:425-899-6300
Mailing Address - Fax:425-899-6301
Practice Address - Street 1:12040 NE 128TH ST # MS -74
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3013
Practice Address - Country:US
Practice Address - Phone:425-899-6300
Practice Address - Fax:425-899-6301
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000069931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical