Provider Demographics
NPI:1386801942
Name:KEEHLER, LEVI TAYLOR (MS, LPC, LADC, CPS)
Entity type:Individual
Prefix:MR
First Name:LEVI
Middle Name:TAYLOR
Last Name:KEEHLER
Suffix:
Gender:M
Credentials:MS, LPC, LADC, CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 MAHANEY AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-5795
Mailing Address - Country:US
Mailing Address - Phone:918-901-9300
Mailing Address - Fax:918-901-9339
Practice Address - Street 1:2021 MAHANEY AVE STE 4
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-5795
Practice Address - Country:US
Practice Address - Phone:918-901-9300
Practice Address - Fax:918-901-9339
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK606101YA0400X
OK3992101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health