Keith Hageman, LPC
Counselor, Professional in Casper, WY. Individual provider (NPI-1).
NPI number1629779012
StatusActive
Last updated in NPPESAug 28, 2024
Details
- NPI
- 1629779012
- Entity type
- Individual (NPI-1)
- Name
- Mr. Keith Hageman
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2023
- Certification date
- Aug 28, 2024
- Last updated
- Aug 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | LPC-2336 | WY | Yes |
Practice location
5000 Blackmore RdCasper, WY 82609-3345
Phone 307-233-6000 · Fax 307-233-6089
Mailing address
5000 Blackmore RdCasper, WY 82609-3345
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