Keene, Kristen A

Keene, Kristen A is an sole proprietor health care provider with primary practice located at 127 F St Ste 202 , Brunswick GA 31520-6788. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Keene, Kristen A can be contacted via phone (912) 319-4041.

Contact Information

Primary practice address
127 F St Ste 202 Brunswick GA 31520-6788
Phone: (912) 319-4041
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC011189 Georgia
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC011189 Georgia

Profile Details

NPI number 1013550250
LBN Legal business name Keene, Kristen A
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2019
Last updated Jan 22nd, 2021 - about 3 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 1013550250 NPPES
Georgia Other 09637169 AMERIGROUP
Georgia MEDICAID 003229861A AMERIGROUP

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