Provider Demographics
NPI:1457603243
Name:HARRYHILL, KEITH D (LMHCCMHCMPABSW)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:D
Last Name:HARRYHILL
Suffix:
Gender:
Credentials:LMHCCMHCMPABSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 N NOVA RD STE 104C
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4420
Mailing Address - Country:US
Mailing Address - Phone:386-280-4789
Mailing Address - Fax:
Practice Address - Street 1:533 N NOVA RD STE 104C
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4420
Practice Address - Country:US
Practice Address - Phone:386-280-4789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25516101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health