Provider Demographics
NPI:1891681680
Name:HOWARD, KEILYN MALIA (MSW, APSW)
Entity type:Individual
Prefix:
First Name:KEILYN
Middle Name:MALIA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MSW, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E GORHAM ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1547
Mailing Address - Country:US
Mailing Address - Phone:773-682-9639
Mailing Address - Fax:
Practice Address - Street 1:1943 WINNEBAGO ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5314
Practice Address - Country:US
Practice Address - Phone:608-298-8367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI135550-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker