Provider Demographics
NPI:1821134800
Name:KEIF, LORELEI (LCSW)
Entity Type:Individual
Prefix:
First Name:LORELEI
Middle Name:
Last Name:KEIF
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 1:210 N BETTY LN
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4702
Mailing Address - Country:US
Mailing Address - Phone:727-639-4266
Mailing Address - Fax:
Practice Address - Street 1:401 CORBETT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-7309
Practice Address - Country:US
Practice Address - Phone:727-639-4266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 2813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ-4758Medicare ID - Type UnspecifiedMEDICARE #