Provider Demographics
NPI:1528076486
Name:KEELER, KAREN M (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:KEELER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30375 NORTHWESTERN HIGHWAY,
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3299
Mailing Address - Country:US
Mailing Address - Phone:248-254-3350
Mailing Address - Fax:248-254-3333
Practice Address - Street 1:30665 NORTHWESTERN HWY
Practice Address - Street 2:STE 255
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3144
Practice Address - Country:US
Practice Address - Phone:248-254-3332
Practice Address - Fax:248-254-3333
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKK0333971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIKK033397OtherLICENSE