Provider Demographics
NPI:1578759007
Name:KEE, SUSANNE (LISW)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:
Last Name:KEE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 RANCH CLUB RD.
Mailing Address - Street 2:PMB 408
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-6610
Mailing Address - Country:US
Mailing Address - Phone:575-388-2414
Mailing Address - Fax:575-388-2457
Practice Address - Street 1:610 N SILVER ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-6779
Practice Address - Country:US
Practice Address - Phone:575-388-2414
Practice Address - Fax:575-388-2457
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-059771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical