Healthcare Provider Details

I. General information

NPI: 1871407361
Provider Name (Legal Business Name): ANNE HOWELL KELLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 DUE WEST RD
POWDER SPRINGS GA
30127-4302
US

IV. Provider business mailing address

5145 DUE WEST RD
POWDER SPRINGS GA
30127-4302
US

V. Phone/Fax

Practice location:
  • Phone: 470-308-4200
  • Fax:
Mailing address:
  • Phone: 470-308-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCSW004529
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: