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NPI Code Detail

MEDICARE: JENNIFER KEYS LCSW

MEDICARE: JENNIFER KEYS LCSW
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
11041C0700XClinical Social WorkerLMSW-33282ID
21041C0700XClinical Social Worker31367MT

General Provider Information

NPI Number : 1528475134
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KEYS LCSW
Provider Business Mailing Address
First Line : 4827 POTTER PARK LOOP
Second Line :
City : MISSOULA
State : MT
Zip : 59808-9601
Country : US
Telephone Number : 406-202-8035
Fax Number :
Provider Business Practice Location Address
First Line : 3885 W BROADWAY ST
Second Line :
City : MISSOULA
State : MT
Zip : 59808-5796
Country : US
Telephone Number : 406-202-8035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2014
Last Update Date : 10/01/2024

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Directions to “ JENNIFER KEYS LCSW” Practice Location

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