Provider Demographics
NPI:1861971855
Name:TOWNLEY, KEITH AARON (BS,BA)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:AARON
Last Name:TOWNLEY
Suffix:
Gender:M
Credentials:BS,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 MAIN ST STE B4
Mailing Address - Street 2:
Mailing Address - City:BUZZARDS BAY
Mailing Address - State:MA
Mailing Address - Zip Code:02532-3251
Mailing Address - Country:US
Mailing Address - Phone:401-835-2620
Mailing Address - Fax:
Practice Address - Street 1:258 MAIN ST STE B4
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02532-3251
Practice Address - Country:US
Practice Address - Phone:401-835-2620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health