Provider Demographics
NPI:1639251028
Name:KEA, LUANNE NORRIS (MA, LPC)
Entity Type:Individual
Prefix:
First Name:LUANNE
Middle Name:NORRIS
Last Name:KEA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SOUTH BELTLINE BOULEVARD
Mailing Address - Street 2:WM 410
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-600-5420
Mailing Address - Fax:
Practice Address - Street 1:316 BELTLINE BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-3624
Practice Address - Country:US
Practice Address - Phone:803-600-5420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4693101YP2500X, 101YP2500X
213439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health