Provider Demographics
NPI:1063606259
Name:STOP PROGRAMS
Entity type:Organization
Organization Name:STOP PROGRAMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:KEEDY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSOTP, LMFT
Authorized Official - Phone:210-826-8686
Mailing Address - Street 1:8820 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6318
Mailing Address - Country:US
Mailing Address - Phone:210-826-8686
Mailing Address - Fax:210-826-8624
Practice Address - Street 1:8820 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6318
Practice Address - Country:US
Practice Address - Phone:210-826-8686
Practice Address - Fax:210-826-8624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty