Provider Demographics
NPI:1720166689
Name:KEAHEY, CAROL R (MS, LPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:R
Last Name:KEAHEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:PRICE
Other - Last Name:KEAHEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:424 YELLOWSTONE AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-9309
Mailing Address - Country:US
Mailing Address - Phone:307-578-2720
Mailing Address - Fax:307-578-2325
Practice Address - Street 1:1205 4TH ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3707
Practice Address - Country:US
Practice Address - Phone:305-292-6843
Practice Address - Fax:305-292-6723
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1359101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional