Provider Demographics
NPI:1770828782
Name:WINFIELD, KEITH L (LCDC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:L
Last Name:WINFIELD
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13207 WRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-5000
Mailing Address - Country:US
Mailing Address - Phone:512-697-8687
Mailing Address - Fax:
Practice Address - Street 1:13207 WRIGHT RD
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-5000
Practice Address - Country:US
Practice Address - Phone:512-697-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-02
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12003101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)