Provider Demographics
NPI:1104434281
Name:KEELEY PSYCHIATRY LLC
Entity type:Organization
Organization Name:KEELEY PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-399-3838
Mailing Address - Street 1:33 W FRANKLIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4863
Mailing Address - Country:US
Mailing Address - Phone:240-200-0961
Mailing Address - Fax:240-201-3033
Practice Address - Street 1:33 W FRANKLIN ST STE 201
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4863
Practice Address - Country:US
Practice Address - Phone:240-200-0961
Practice Address - Fax:240-201-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty