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General NPI Number Information
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NPI Number | 1891177325
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Entity Type | Organization
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Legal Business Name | KEITH HAAS, LCSW, PLLC
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Dates
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Enumeration Date | 06/20/2015
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 501 DARBY CREEK RD 3
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City | LEXINGTON
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State | KY
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Zip | 40509-1604
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Country | US
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Telephone | 859-488-1236
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Fax |
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Provider Business Mailing Address
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Address Line | 3277 MADDENHURST CT
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City | LEXINGTON
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State | KY
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Zip | 40517-2866
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MR. KEITH PAUL HAAS
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Credential | LCSW
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Telephone | 859-488-1236
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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 | 3627
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License Number State | KY
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