Provider Demographics
NPI:1306738992
Name:SALISBURY, KEEGAN (BS, CFLE-P, T/S)
Entity type:Individual
Prefix:
First Name:KEEGAN
Middle Name:
Last Name:SALISBURY
Suffix:
Gender:M
Credentials:BS, CFLE-P, T/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 169TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46323-2068
Mailing Address - Country:US
Mailing Address - Phone:231-245-4510
Mailing Address - Fax:
Practice Address - Street 1:2200 169TH ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323-2068
Practice Address - Country:US
Practice Address - Phone:231-245-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No183700000XPharmacy Service ProvidersPharmacy Technician