Provider Information for 1538214440
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Ms. ELIZABETH ANN KEENEY LCSW, CASAC
Sex: Female
NPI: 1538214440
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||||||||||
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| NPI | 1538214440 | ||||||||||||||||||||||||||||
| Enumeration Date | 2007-01-24 | ||||||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||||||
| Mailing Address | 380 HENDERSON AVE STATEN ISLAND, NY 10310-1617 United States Phone: 718-981-6158 | Fax:718-447-8400 | ||||||||||||||||||||||||||||
| Primary Practice Address | 482 BARD AVE STATEN ISLAND, NY 10310-2105 United States Phone: 718-981-6158 | Fax:718-447-8400 | ||||||||||||||||||||||||||||
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