Provider Demographics
NPI:1215057153
Name:CONANT, KEITH DOUGLAS (LMHC)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:DOUGLAS
Last Name:CONANT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 HIGHLAND AVE
Mailing Address - Street 2:NORTH SHORE MEDICAL CENTER
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2714
Mailing Address - Country:US
Mailing Address - Phone:978-354-4704
Mailing Address - Fax:
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:NORTH SHORE MEDICAL CENTER
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2714
Practice Address - Country:US
Practice Address - Phone:978-354-4704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health