Provider Demographics
NPI:1689081671
Name:KEEL, JAIME LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:LEE
Last Name:KEEL
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 1:246 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13208-2407
Mailing Address - Country:US
Mailing Address - Phone:914-384-5363
Mailing Address - Fax:
Practice Address - Street 1:6820 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13211-1321
Practice Address - Country:US
Practice Address - Phone:315-433-2296
Practice Address - Fax:315-431-8437
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092308104100000X
NY0887191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker