Individual
JENNIFER ARCHER KEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMFT, LCAS
Contact information
Practice address
101 COLVARD ST, JEFFERSON, NC 28640-9797
(336) 246-2109
(336) 246-2287
Mailing address
284 EXECUTIVE PARK DRIVE, SUITE 100, CONCORD, NC 28025-1894
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-3211
NC
106H00000X
Marriage & Family Therapist
Primary
1609
NC
Other
Enumeration date
01/11/2012
Last updated
05/04/2017
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