Provider Demographics
NPI:1780241612
Name:HAMM, KEELIE (LPC-C)
Entity type:Individual
Prefix:
First Name:KEELIE
Middle Name:
Last Name:HAMM
Suffix:
Gender:F
Credentials:LPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 S HARVARD AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-6126
Mailing Address - Country:US
Mailing Address - Phone:918-982-6150
Mailing Address - Fax:918-982-6101
Practice Address - Street 1:3010 S HARVARD AVE STE 110
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-6126
Practice Address - Country:US
Practice Address - Phone:918-982-6150
Practice Address - Fax:918-982-6101
Is Sole Proprietor?:No
Enumeration Date:2019-05-27
Last Update Date:2019-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health