Doctor Name: | KEITH EDWARD WHEELER |
NPI Number: | 1063402915 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | CSW003035 |
Business Practice Address: | 1061 Harmon Ave Ste 1d03 Winn Army Community Hospital Fort Stewart, GA - 313145641 |
Business Phone Number: | 9123156730 |
Business Fax Number: | |
Mailing Address: | 1061 Harmon Ave Ste 1d03, Winn Army Community Hospital FORT STEWART |
State: | GA |
Postal Code: | 313145641 |
Phone Number: | 9123156730 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2005 |
NPI Last Update Date: | 09/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CSW003035 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |