MEDICARE: MRS. JOYCE HELEN KEENE LPC

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	101YM0800X	Mental Health Counselor	0000564	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PC-0000564	OTHER	DE	LPC
2	38009	OTHER		NBCC

General Provider Information

NPI Number	:	1952678120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOYCE HELEN KEENE LPC

Provider Business Mailing Address
First Line	:	2247 BAY HORSE LN
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95835-2176
Country	:	US
Telephone Number	:	215-407-0463
Fax Number	:

Provider Business Practice Location Address
First Line	:	2247 BAY HORSE LN
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95835-2176
Country	:	US
Telephone Number	:	215-407-0463
Fax Number	:

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

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	09/24/2019

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