Healthcare Provider Details

I. General information

NPI: 1538083837
Provider Name (Legal Business Name): COREY KEELING QMHP-T , CSAC S, BA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 HENRY CLAY RD
NEWPORT NEWS VA
23601-3155
US

IV. Provider business mailing address

138 HENRY CLAY RD
NEWPORT NEWS VA
23601-3155
US

V. Phone/Fax

Practice location:
  • Phone: 757-876-4127
  • Fax:
Mailing address:
  • Phone: 757-876-4127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: