Provider Demographics
NPI:1366907248
Name:BRANNIGAN, KEELY (LPC)
Entity type:Individual
Prefix:
First Name:KEELY
Middle Name:
Last Name:BRANNIGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17680 NW WILLIS RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-8054
Mailing Address - Country:US
Mailing Address - Phone:971-261-8282
Mailing Address - Fax:
Practice Address - Street 1:17680 NW WILLIS RD
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-8054
Practice Address - Country:US
Practice Address - Phone:971-261-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC9091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health