Provider Demographics
NPI:1407673791
Name:MCKEEL, COLLEEN SUSANNAH (LCMHCA, MED)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:SUSANNAH
Last Name:MCKEEL
Suffix:
Gender:F
Credentials:LCMHCA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 KILDAIRE FARM RD STE 307
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-7600
Mailing Address - Country:US
Mailing Address - Phone:919-806-7356
Mailing Address - Fax:
Practice Address - Street 1:1140 KILDAIRE FARM RD STE 307
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7600
Practice Address - Country:US
Practice Address - Phone:919-806-7356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19517101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health