Provider Demographics
NPI:1568216349
Name:KEATING, CHRISTINE MARIE (PLPC, NCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:KEATING
Suffix:
Gender:F
Credentials:PLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12166 OLD BIG BEND RD STE 204
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6836
Mailing Address - Country:US
Mailing Address - Phone:314-822-8888
Mailing Address - Fax:888-909-9204
Practice Address - Street 1:12166 OLD BIG BEND RD STE 204
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6836
Practice Address - Country:US
Practice Address - Phone:314-822-8888
Practice Address - Fax:888-909-9204
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022028870101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional