Provider Demographics
NPI:1851638589
Name:KEATON, NADIRA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NADIRA
Middle Name:
Last Name:KEATON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 S BROAD ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08608-2502
Mailing Address - Country:US
Mailing Address - Phone:609-222-5037
Mailing Address - Fax:
Practice Address - Street 1:354 S BROAD ST
Practice Address - Street 2:SUITE 108
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-2502
Practice Address - Country:US
Practice Address - Phone:609-222-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00452600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional