Provider Demographics
NPI:1649158270
Name:KEYES, MELISSA ANNE (CSW INTERN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:KEYES
Suffix:
Gender:F
Credentials:CSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 W RIVERS EDGE LN
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-1815
Mailing Address - Country:US
Mailing Address - Phone:702-572-5181
Mailing Address - Fax:
Practice Address - Street 1:40 N 300 E STE 203
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2909
Practice Address - Country:US
Practice Address - Phone:435-574-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor