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NPI Code Detail

MEDICARE: MR. JAMES B KEEDY LPC LMFT LSOTP

MEDICARE:  MR. JAMES B KEEDY  LPC LMFT LSOTP
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
1101Y00000XCounselor9498TX
2101YA0400XAddiction (Substance Use Disorder) Counselor6192TX
3101YP2500XProfessional Counselor10216TX
4106H00000XMarriage & Family Therapist3594TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821214107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES B KEEDY LPC LMFT LSOTP
Provider Business Mailing Address
First Line : 8820 BROADWAY ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78217-6318
Country : US
Telephone Number : 210-826-8686
Fax Number : 210-826-8624
Provider Business Practice Location Address
First Line : 8820 BROADWAY ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78217-6318
Country : US
Telephone Number : 210-826-8686
Fax Number : 210-826-8624
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 01/16/2009

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Directions to “ MR. JAMES B KEEDY LPC LMFT LSOTP” Practice Location

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