Provider Demographics
NPI:1245112226
Name:KEEGAN, KANDICE (CADACII)
Entity type:Individual
Prefix:MRS
First Name:KANDICE
Middle Name:
Last Name:KEEGAN
Suffix:
Gender:F
Credentials:CADACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 AIRPORT PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1439
Mailing Address - Country:US
Mailing Address - Phone:317-883-5318
Mailing Address - Fax:317-888-2138
Practice Address - Street 1:65 AIRPORT PKWY STE 104
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1439
Practice Address - Country:US
Practice Address - Phone:317-883-5318
Practice Address - Fax:317-888-2138
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INC2-5005101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)