Provider Demographics
NPI:1568547966
Name:CHEW, KEITH FORREST (LPC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:FORREST
Last Name:CHEW
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:KEITH
Other - Middle Name:FORREST
Other - Last Name:CHEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LPC,
Mailing Address - Street 1:902 ARLINGTON CTR # 255
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-2883
Mailing Address - Country:US
Mailing Address - Phone:580-310-2513
Mailing Address - Fax:
Practice Address - Street 1:902 ARLINGTON CTR # 255
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-2883
Practice Address - Country:US
Practice Address - Phone:580-310-2513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2089101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health