Provider Demographics
NPI:1174088462
Name:KEEGAN, ELLIOTT HUDSON (LPCC)
Entity type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:HUDSON
Last Name:KEEGAN
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 SKIFF LN
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9527
Mailing Address - Country:US
Mailing Address - Phone:504-377-7015
Mailing Address - Fax:
Practice Address - Street 1:1900 FAIRGROVE AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-1966
Practice Address - Country:US
Practice Address - Phone:513-785-4895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2404278101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional