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General NPI Number Information
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NPI Number | 1639037492
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Entity Type | Organization
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Legal Business Name | KEELEY MENDENHALL, LCSW, LLC
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 450 SIMMONS WAY
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City | KAYSVILLE
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State | UT
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Zip | 84037-6721
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Country | US
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Telephone | 801-829-8561
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Fax |
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Provider Business Mailing Address
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Address Line | 84 E PARK DR
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City | KAYSVILLE
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State | UT
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Zip | 84037-2821
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Country | US
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Telephone | 801-829-8561
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Fax |
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Authorized Official
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Title or Position | LCSW/OWNER
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Name | KEELEY MENDENHALL
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Credential | LCSW
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Telephone | 801-829-8561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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