Doctor Name: | MR. KEITH THOMAS RIPLEY |
NPI Number: | 1295021798 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LPC, CADC |
License Number: | 4657 |
Business Practice Address: | 4101 Birney Ave Moosic, PA - 185071323 |
Business Phone Number: | 5709613361 |
Business Fax Number: | 5709613364 |
Mailing Address: | 4101 Birney Ave, MOOSIC |
State: | PA |
Postal Code: | 185071323 |
Phone Number: | 5709613361 |
Fax Number: | 5709613364 |
NPI Enumeration Date: | 06/22/2011 |
NPI Last Update Date: | 06/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 4657 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |