Provider Demographics
NPI:1760212914
Name:KEYS, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KEYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14497 POTOMAC MILLS RD # 1156
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6807
Mailing Address - Country:US
Mailing Address - Phone:703-919-4531
Mailing Address - Fax:
Practice Address - Street 1:14497 POTOMAC MILLS RD # 1156
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6807
Practice Address - Country:US
Practice Address - Phone:240-617-0962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014893101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health