Provider Demographics
NPI:1205924032
Name:KEYSERLING-KRAMER, MARY BETH (MED, LPC, LMFT)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:BETH
Last Name:KEYSERLING-KRAMER
Suffix:
Gender:F
Credentials:MED, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 318
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29465-0318
Mailing Address - Country:US
Mailing Address - Phone:843-810-8647
Mailing Address - Fax:
Practice Address - Street 1:1060B CLIFFWOOD DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3522
Practice Address - Country:US
Practice Address - Phone:843-810-8647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC900101YP2500X
SC2403106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist