MEDICARE: LASANDRA KEYES

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	:	1598611154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASANDRA KEYES

Provider Business Mailing Address
First Line	:	3695 PINOAK ST
Second Line	:
City	:	CLARKSTON
State	:	MI
Zip	:	48348-1380
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3695 PINOAK ST
Second Line	:
City	:	CLARKSTON
State	:	MI
Zip	:	48348-1380
Country	:	US
Telephone Number	:	248-365-5566
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ LASANDRA KEYES ” Practice Location

Language	Start Address	Practice Location

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