Provider Demographics
NPI:1821139395
Name:WEINSTEIN, KEEF (LCPC)
Entity Type:Individual
Prefix:MR
First Name:KEEF
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9438 73RD ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7677
Mailing Address - Country:US
Mailing Address - Phone:224-715-0100
Mailing Address - Fax:
Practice Address - Street 1:27255 N FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-9115
Practice Address - Country:US
Practice Address - Phone:847-487-9455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional