Healthcare Provider Details

I. General information

NPI: 1720166689
Provider Name (Legal Business Name): CAROL R KEAHEY MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL PRICE KEAHEY MS, LPC

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 4TH ST
KEY WEST FL
33040-3707
US

IV. Provider business mailing address

424 YELLOWSTONE AVE SUITE 220
CODY WY
82414-9309
US

V. Phone/Fax

Practice location:
  • Phone: 305-292-6843
  • Fax: 305-292-6723
Mailing address:
  • Phone: 307-578-2720
  • Fax: 307-578-2325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1359
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: