Provider Demographics
NPI:1366403677
Name:KARSTENS, KEITH A (PSYD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:A
Last Name:KARSTENS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 4TH ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101-1750
Mailing Address - Country:US
Mailing Address - Phone:712-234-0220
Mailing Address - Fax:712-234-0225
Practice Address - Street 1:600 4TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1750
Practice Address - Country:US
Practice Address - Phone:712-234-0220
Practice Address - Fax:712-234-0225
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00911103T00000X
IA00404103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1240408Medicaid
IA37250OtherWELLMARK
IAI13102Medicare PIN