1093524944 NPI number — MARGARET WILKES KEATING MS, LCGC

Table of content: MARGARET WILKES KEATING MS, LCGC (NPI 1093524944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093524944 NPI number — MARGARET WILKES KEATING MS, LCGC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEATING
Provider First Name:
MARGARET
Provider Middle Name:
WILKES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, LCGC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WILKES
Provider Other First Name:
MARGARET
Provider Other Middle Name:
JEAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, CGC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093524944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4993 OHEAR AVE APT 1107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29405-4987
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-995-0912
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3520 W MONTAGUE AVE STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29418-6083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-746-1001
Provider Business Practice Location Address Fax Number:
843-735-5097
Provider Enumeration Date:
01/06/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 170300000X , with the licence number:  93 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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