Provider Demographics
NPI:1962158337
Name:KEITER, ALLISON BRIGHT (MSED, LPC, NCC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:BRIGHT
Last Name:KEITER
Suffix:
Gender:F
Credentials:MSED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 OXFORD AVE UNIT 7328
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3020
Mailing Address - Country:US
Mailing Address - Phone:215-701-9063
Mailing Address - Fax:
Practice Address - Street 1:7311 OXFORD AVE UNIT 7328
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-3020
Practice Address - Country:US
Practice Address - Phone:215-701-9063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC104243101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health