Provider Demographics
NPI:1992215388
Name:KEITH, KAREN ELAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELAINE
Last Name:KEITH
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 1:3117 COONEY DR STE 201
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0229
Mailing Address - Country:US
Mailing Address - Phone:406-461-1468
Mailing Address - Fax:
Practice Address - Street 1:3117 COONEY DR STE 201
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0229
Practice Address - Country:US
Practice Address - Phone:406-461-1468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-257131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical