Individual
JASON WILLIAM KEICHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
215 STRATTON RD, RUTLAND, VT 05701-4621
(800) 468-9118
Mailing address
10 NORTH MAIN ST, CORTLAND, NY 13045
(607) 753-0234
(607) 753-0286
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
068800
NY
1041C0700X
Clinical Social Worker
Primary
085469
NY
1041C0700X
Clinical Social Worker
089.0134169
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01079267
—
NY
Enumeration date
10/12/2006
Last updated
03/19/2019
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