Provider Demographics
NPI:1821002676
Name:KEYPOINT HEALTH
Entity Type:Organization
Organization Name:KEYPOINT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/C&A COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:KESTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-625-1600
Mailing Address - Street 1:5842 WYNDHAM CIR APT 204
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3267
Mailing Address - Country:US
Mailing Address - Phone:410-715-4695
Mailing Address - Fax:
Practice Address - Street 1:135 N PARKE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2428
Practice Address - Country:US
Practice Address - Phone:443-625-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1041C0700X251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC032M389Medicare ID - Type UnspecifiedLCSW-C