Provider Demographics
NPI:1780420661
Name:KEYSER, WILLIAM MANSFIELD (LCSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MANSFIELD
Last Name:KEYSER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 THE LAKES BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6814
Mailing Address - Country:US
Mailing Address - Phone:904-651-2954
Mailing Address - Fax:
Practice Address - Street 1:140 THE LAKES BLVD STE 210
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6814
Practice Address - Country:US
Practice Address - Phone:904-651-2954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0075411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical