Provider Demographics
NPI:1205256765
Name:BRANCH, KEOSHA MEKA-BEYANKA (LPC, NCC, ACS)
Entity type:Individual
Prefix:DR
First Name:KEOSHA
Middle Name:MEKA-BEYANKA
Last Name:BRANCH
Suffix:
Gender:F
Credentials:LPC, NCC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 WESTWOOD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4016
Mailing Address - Country:US
Mailing Address - Phone:804-482-0559
Mailing Address - Fax:804-482-2479
Practice Address - Street 1:2405 WESTWOOD AVE STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4016
Practice Address - Country:US
Practice Address - Phone:804-482-0559
Practice Address - Fax:804-482-2479
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional