Individual
JEANNIE KEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1312 KINGS CREST DR, SALEM, VA 24153-5113
(540) 580-8730
Mailing address
1312 KINGS CREST DR, SALEM, VA 24153-5113
(540) 580-8730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904007254
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904007254
LICENSE
VA
Enumeration date
08/04/2022
Last updated
08/04/2022
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