Provider Demographics
NPI:1619043031
Name:KEYS, PAMELA JOANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JOANN
Last Name:KEYS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2522
Mailing Address - Country:US
Mailing Address - Phone:847-446-6955
Mailing Address - Fax:847-446-6957
Practice Address - Street 1:690 OAK ST
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2522
Practice Address - Country:US
Practice Address - Phone:847-446-6955
Practice Address - Fax:847-446-6957
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071732104100000X
IL1490174411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker