Healthcare Provider Details

I. General information

NPI: 1871042218
Provider Name (Legal Business Name): MAUREEN ANN KEATING LPCC-S, LICDC-CS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 COBURN ST
AKRON OH
44311-1459
US

IV. Provider business mailing address

838 COBURN ST
AKRON OH
44311-1459
US

V. Phone/Fax

Practice location:
  • Phone: 330-315-3742
  • Fax: 330-208-2136
Mailing address:
  • Phone: 330-315-3742
  • Fax: 330-208-2136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number954363
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE1907
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: