Provider Demographics
NPI:1285919795
Name:HARRINGTON, KEITH (LCSW)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 RIO EAST CT
Mailing Address - Street 2:STE C
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8004
Mailing Address - Country:US
Mailing Address - Phone:434-963-0324
Mailing Address - Fax:434-971-5625
Practice Address - Street 1:875 RIO EAST CT
Practice Address - Street 2:STE C
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8004
Practice Address - Country:US
Practice Address - Phone:434-963-0324
Practice Address - Fax:434-971-5625
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040063051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical