Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Keenan P Tyner, LCSW

Individual provider Counselor · NPI 1023347911

Mr. Keenan P Tyner, LCSW is a Counselor in Ukiah, California. Licensed in California. Registered with an NPI since 2009.

Licensed in
CA
In the registry since
2009
Specialties on file
5
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2240 Old River Rd
Ukiah, CA 95482-6103
Phone: (707) 467-5181
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW101659 (CA)
Counselor Taxonomy 101Y00000X
Mental Health Counselor Taxonomy 101YM0800X · Licence 69833 (CA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 69833 (CA)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1023347911
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 23, 2009
Last updated in NPPESMarch 30, 2023
Certification dateMarch 30, 2023

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