MEDICARE: KEEGAN KRANTZ LPC

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
2	101YP2500X	Professional Counselor	5397	MN

General Provider Information

NPI Number	:	1912708306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEEGAN KRANTZ LPC

Provider Business Mailing Address
First Line	:	120 LABREE AVE S
Second Line	:
City	:	THIEF RIVER FALLS
State	:	MN
Zip	:	56701-2819
Country	:	US
Telephone Number	:	218-683-4351
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 LABREE AVE S
Second Line	:
City	:	THIEF RIVER FALLS
State	:	MN
Zip	:	56701-2819
Country	:	US
Telephone Number	:	218-683-4351
Fax Number	:

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

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	05/05/2026

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Directions to “ KEEGAN KRANTZ LPC” Practice Location

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