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NPI Code Detail

MEDICARE: KEITH D. HARRYHILL LMHC.CMHC.MPA.BSW.

MEDICARE: KEITH D. HARRYHILL LMHC.CMHC.MPA.BSW.
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
1101YM0800XMental Health CounselorMH25516FL

General Provider Information

NPI Number : 1457603243
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH D. HARRYHILL LMHC.CMHC.MPA.BSW.
Provider Business Mailing Address
First Line : 533 N NOVA RD STE 104C
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-4420
Country : US
Telephone Number : 386-280-4789
Fax Number :
Provider Business Practice Location Address
First Line : 533 N NOVA RD STE 104C
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-4420
Country : US
Telephone Number : 386-280-4789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2012
Last Update Date : 04/26/2025

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