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General NPI Number Information
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NPI Number | 1407396187
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Entity Type | Individual
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Provider Name | KEEGAN FERRIS LPC
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Gender | Male
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 800 MONROE AVE NW STE 319
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1451
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Country | US
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Telephone | 616-275-4646
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BURTON ST SE APT 2
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City | GRAND RAPIDS
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State | MI
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Zip | 49507
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Country | US
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Telephone | 765-749-0071
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | F620465744062
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6451019344
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License Number State | MI
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