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General NPI Number Information
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NPI Number | 1598094898
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Entity Type | Individual
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Provider Name | SARAH K. KEELY LPC
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Gender | Female
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 491 CARLISLE DR STE B
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City | HERNDON
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State | VA
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Zip | 20170-4895
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Country | US
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Telephone | 571-269-3108
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Fax |
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Provider Business Mailing Address
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Address Line | 1488 AUTUMN RIDGE CIR
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City | RESTON
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State | VA
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Zip | 20194-1561
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Country | US
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Telephone | 571-269-3108
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701004688
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License Number State | VA
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