Provider Demographics
NPI:1578739462
Name:KEYMER, CAROL ANN (LPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:KEYMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6078 OLDE STAGE ROAD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302
Mailing Address - Country:US
Mailing Address - Phone:720-406-7995
Mailing Address - Fax:303-440-8646
Practice Address - Street 1:6078 OLDE STAGE RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-9497
Practice Address - Country:US
Practice Address - Phone:720-406-7995
Practice Address - Fax:303-440-8646
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3323101YM0800X
OK2999101YM0800X
OK2203103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis