Provider Demographics
NPI:1194432351
Name:KEESEN, ARIANA RENEE (MA, LPC-A)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:RENEE
Last Name:KEESEN
Suffix:
Gender:F
Credentials:MA, LPC-A
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:RENEE
Other - Last Name:KEESEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPC-A
Mailing Address - Street 1:750 FORT WORTH AVE APT 439
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-1841
Mailing Address - Country:US
Mailing Address - Phone:720-220-3170
Mailing Address - Fax:
Practice Address - Street 1:3500 OAK LAWN AVE STE 730
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-6721
Practice Address - Country:US
Practice Address - Phone:214-717-9981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84248101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty