Provider Demographics
NPI:1528098951
Name:KESSLER, KEITH (LISW-CP, LCSW,LCSW-C)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:KESSLER
Suffix:
Gender:M
Credentials:LISW-CP, LCSW,LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 W MARTINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3187
Mailing Address - Country:US
Mailing Address - Phone:803-278-0880
Mailing Address - Fax:
Practice Address - Street 1:431 W MARTINTOWN RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-3187
Practice Address - Country:US
Practice Address - Phone:803-278-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0043111041C0700X
MD071291041C0700X
SC177561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002836Medicaid
NC2878571AMedicare ID - Type UnspecifiedLCSW GRP # 2335660D