| Doctor Name: | KEITH MCKENZIE |
| NPI Number: | 1003215740 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CADC |
| License Number: | 0656 |
| Business Practice Address: | 332 W Broadway Ste 905 Louisville, KY - 402022133 |
| Business Phone Number: | 5025879737 |
| Business Fax Number: | |
| Mailing Address: | 332 W Broadway Ste 905, LOUISVILLE |
| State: | KY |
| Postal Code: | 402022133 |
| Phone Number: | 5025879737 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2014 |
| NPI Last Update Date: | 08/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0656 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |