Provider Demographics
NPI:1598128407
Name:MCKEITHEN, TRISHA (LPC)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:MCKEITHEN
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 1:11 E BEVERLEY ST STE 9
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-4364
Mailing Address - Country:US
Mailing Address - Phone:251-272-9460
Mailing Address - Fax:
Practice Address - Street 1:11 E BEVERLEY ST STE 9
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-4364
Practice Address - Country:US
Practice Address - Phone:251-272-9460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1939101YM0800X
AL3807101YM0800X, 101YP2500X
VA0701011181101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health