Provider Demographics
NPI:1588142418
Name:KEYWORTH, MEGHAN MARIE (LPC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:MARIE
Last Name:KEYWORTH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANNON
Mailing Address - State:PA
Mailing Address - Zip Code:17020-9700
Mailing Address - Country:US
Mailing Address - Phone:717-798-4789
Mailing Address - Fax:
Practice Address - Street 1:160 S PROGRESS AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4636
Practice Address - Country:US
Practice Address - Phone:717-602-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010562101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional