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General NPI Number Information
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NPI Number | 1306979802
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Entity Type | Organization
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Legal Business Name | MARTHA A. KEIL LCSW PC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1470 N MAIN ST STE B
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City | BOUNTIFUL
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State | UT
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Zip | 84010-5996
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Country | US
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Telephone | 801-298-5008
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Fax | 801-547-0440
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Provider Business Mailing Address
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Address Line | 591 N 125 E
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City | KAYSVILLE
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State | UT
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Zip | 84037-1403
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Country | US
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Telephone | 801-547-0440
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Fax | 801-547-0440
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARTHA A KEIL
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Credential | LCSW
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Telephone | 801-298-5008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 94-141675-3501
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 94-141675-3501
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 94-141675-3501
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License Number State | UT
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