Provider Demographics
NPI:1245881952
Name:KEYS, ANGELA (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:KEYS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14843 ENERGY WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5757
Mailing Address - Country:US
Mailing Address - Phone:952-209-1644
Mailing Address - Fax:952-423-0365
Practice Address - Street 1:14843 ENERGY WAY
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5757
Practice Address - Country:US
Practice Address - Phone:952-209-1644
Practice Address - Fax:952-423-0365
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3962101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty