Individual
KEITH MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
332 W BROADWAY STE 905, LOUISVILLE, KY 40202-2133
(502) 587-9737
Mailing address
332 W BROADWAY STE 905, LOUISVILLE, KY 40202-2133
(502) 587-9737
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0656
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100323580
—
KY
Enumeration date
08/19/2014
Last updated
10/31/2017
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