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Individual
LARRY KELLER
Active
Individual
LARRY KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSATP, LCAS, CAADC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0718000420
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103300
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000420
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
1436
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CSAC20095
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-234233
NC
Other
Enumeration date
06/25/2016
Last updated
09/17/2026
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