Provider Demographics
NPI:1801993985
Name:PETER W. KEELIN, PH.D., F.L.P., L.L.C.
Entity type:Organization
Organization Name:PETER W. KEELIN, PH.D., F.L.P., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KEELIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-625-7320
Mailing Address - Street 1:6300 SASHABAW RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2269
Mailing Address - Country:US
Mailing Address - Phone:248-625-7320
Mailing Address - Fax:
Practice Address - Street 1:6300 SASHABAW RD
Practice Address - Street 2:SUITE D
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2269
Practice Address - Country:US
Practice Address - Phone:248-625-7320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty