MEDICARE: JOHN MITCHELL KEIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1134933948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MITCHELL KEIM

Provider Business Mailing Address
First Line	:	41 LENOX POINTE NE STE B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-7424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 LENOX POINTE NE STE B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-7424
Country	:	US
Telephone Number	:	678-597-8084
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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Directions to “ JOHN MITCHELL KEIM ” Practice Location

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