Provider Demographics
NPI:1952824518
Name:KEITH-PYHALA, ALETHEA MARIE (LMHC, CMHS)
Entity Type:Individual
Prefix:
First Name:ALETHEA
Middle Name:MARIE
Last Name:KEITH-PYHALA
Suffix:
Gender:F
Credentials:LMHC, CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 494
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-0494
Mailing Address - Country:US
Mailing Address - Phone:360-463-1148
Mailing Address - Fax:
Practice Address - Street 1:324 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-4502
Practice Address - Country:US
Practice Address - Phone:360-463-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60179258101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health