Provider Demographics
NPI:1518470020
Name:AMY KEEFER, LLC
Entity Type:Organization
Organization Name:AMY KEEFER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LICHTENSTEIN
Authorized Official - Last Name:KEEFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-581-9855
Mailing Address - Street 1:1202 S PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-5943
Mailing Address - Country:US
Mailing Address - Phone:406-581-9855
Mailing Address - Fax:406-587-9422
Practice Address - Street 1:1600 ELLIS ST STE 1C
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8837
Practice Address - Country:US
Practice Address - Phone:406-581-9855
Practice Address - Fax:406-587-9422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty