Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MARVIN THEADORE KEATON III, MA, LCMHCS, LCAS,CSI
ActiveMR. MARVIN THEADORE KEATON III, MA, LCMHCS, LCAS,CSI is a Professional Counselor healthcare provider located in PLEASANT GARDEN, North Carolina. NPI 1942518048 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · PLEASANT GARDEN, NC
Registration Details
- NPI Number
- 1942518048
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 23, 2010 (15.865614312703 yrs)
- Last Updated
- May 25, 2021
- Licenses
-
LCAS-23799 (NC)7790S (NC)
Practice Information
- Address
-
6715 HOCKETT COUNTRY LNPLEASANT GARDEN, NC, 273138262Browse NC providers · Browse ZIP 27313
- Phone
- 3365080714
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Mental Health Counselor
- Additional Specialty
- Professional Counselor
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.