Provider Demographics
NPI:1720649643
Name:KEELER, DEBORAH DENISE (LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:DENISE
Last Name:KEELER
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 INLET QUAY APT I
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9297
Mailing Address - Country:US
Mailing Address - Phone:757-436-6049
Mailing Address - Fax:
Practice Address - Street 1:712 INLET QUAY APT I
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-9297
Practice Address - Country:US
Practice Address - Phone:757-436-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002277101YP2500X
VA0717000348106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
13983739OtherCAQH