MEDICARE: AMBER KEELER MSW, LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6801103961	MI
2	1041C0700X	Clinical Social Worker	68011033961	MI

General Provider Information

NPI Number	:	1770954695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER KEELER MSW, LMSW

Provider Business Mailing Address
First Line	:	1661 FARMINGTON RD
Second Line	:
City	:	GARDEN CITY
State	:	MI
Zip	:	48135-1149
Country	:	US
Telephone Number	:	313-784-8806
Fax Number	:

Provider Business Practice Location Address
First Line	:	1777 AXTELL DR STE 100
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4400
Country	:	US
Telephone Number	:	248-862-1171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	10/20/2022

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