Provider Demographics
NPI:1902591647
Name:HARPER, KESHAWN (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:KESHAWN
Middle Name:
Last Name:HARPER
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 ALONA DR APT 3
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-4803
Mailing Address - Country:US
Mailing Address - Phone:419-461-8229
Mailing Address - Fax:
Practice Address - Street 1:670 MERIDIAN WAY
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7648
Practice Address - Country:US
Practice Address - Phone:614-600-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.22040711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical