Austin, Keitha Maureen

Austin, Keitha Maureen is an sole proprietor health care provider with primary practice located at 12725 Mcmanus Blvd Suite 2G, Newport News VA 23602-4402. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Austin, Keitha Maureen can be contacted via phone (757) 874-1676.

Contact Information

Primary practice address
12725 Mcmanus Blvd Suite 2G Newport News VA 23602-4402
Phone: (757) 874-1676
Fax: (757) 874-2226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0904002555 Virginia

Profile Details

NPI number 1417954686
LBN Legal business name Austin, Keitha Maureen
Credentials LCSW, BCD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2005
Last updated Jan 18th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417954686 NPPES
Virginia MEDICAID 1417954686

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