Provider Demographics
NPI:1851458475
Name:KEYSTONE COUNSELING SERVICES, PC
Entity Type:Organization
Organization Name:KEYSTONE COUNSELING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PH,D
Authorized Official - Phone:610-282-2575
Mailing Address - Street 1:593 BETHLEHEM PIKE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936-9709
Mailing Address - Country:US
Mailing Address - Phone:215-997-7770
Mailing Address - Fax:215-997-7515
Practice Address - Street 1:593 BETHLEHEM PIKE
Practice Address - Street 2:SUITE 8
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936-9709
Practice Address - Country:US
Practice Address - Phone:215-997-7770
Practice Address - Fax:215-997-7515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-002722-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty