Provider Demographics
NPI:1083423172
Name:KEELY JOHNSON, PLLC
Entity type:Organization
Organization Name:KEELY JOHNSON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KEELY
Authorized Official - Middle Name:DYANE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:210-419-2044
Mailing Address - Street 1:3936 CHERRY TREE DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2309
Mailing Address - Country:US
Mailing Address - Phone:210-419-2044
Mailing Address - Fax:
Practice Address - Street 1:3936 CHERRY TREE DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78108-2309
Practice Address - Country:US
Practice Address - Phone:210-419-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health