Provider Demographics
NPI:1689775157
Name:KEYSTONE COUNSELING SERVICES, PC
Entity Type:Organization
Organization Name:KEYSTONE COUNSELING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-282-2575
Mailing Address - Street 1:343 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-2111
Mailing Address - Country:US
Mailing Address - Phone:610-282-2575
Mailing Address - Fax:610-282-3076
Practice Address - Street 1:343 S 3RD ST
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-2111
Practice Address - Country:US
Practice Address - Phone:610-282-2575
Practice Address - Fax:610-282-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-002722-L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty