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:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013550250 | NPPES |
| Georgia | Other | 09637169 | AMERIGROUP |
| Georgia | MEDICAID | 003229861A | AMERIGROUP |
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