Individual
AMY L KEAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1843 RW BERENDS DR SW, WYOMING, MI 49519-4955
(616) 773-2908
(616) 532-3046
Mailing address
1843 RW BERENDS DR SW, WYOMING, MI 49519-4955
(616) 773-2908
(616) 532-3046
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6401007991
MI
101YM0800X
Mental Health Counselor
6401007991
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712452
—
MI
Enumeration date
12/18/2006
Last updated
12/05/2014
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