Provider Demographics
NPI:1790461648
Name:KELLER COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:KELLER COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:N
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:330-317-9253
Mailing Address - Street 1:4917 LATTASBURG RD.
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691
Mailing Address - Country:US
Mailing Address - Phone:330-317-9253
Mailing Address - Fax:330-234-9908
Practice Address - Street 1:4917 LATTASBURG RD.
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691
Practice Address - Country:US
Practice Address - Phone:330-317-9253
Practice Address - Fax:330-234-9908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty