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General NPI Number Information
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NPI Number | 1124416078
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Entity Type | Individual
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Provider Name | MATTHEW AARON KIEFER CMHC, LPC
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Gender | Male
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 186 BRIANS LAKE RD
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City | MOUNTAIN REST
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State | SC
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Zip | 29664-9111
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Country | US
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Telephone | 864-638-6005
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Fax | 864-638-6099
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Provider Business Mailing Address
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Address Line | 186 BRIANS LAKE RD
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City | MOUNTAIN REST
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State | SC
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Zip | 29664-9111
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Country | US
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Telephone | 864-638-6005
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Fax | 864-638-6099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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