Healthcare Provider Details

I. General information

NPI: 1235507518
Provider Name (Legal Business Name): MARIE ANGELAINE KEEFE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SE FEDERAL HWY
STUART FL
34994-3823
US

IV. Provider business mailing address

2875 WINDSWEPT DR APT 207
LAKE WORTH FL
33462-2496
US

V. Phone/Fax

Practice location:
  • Phone: 772-320-0770
  • Fax:
Mailing address:
  • Phone: 561-201-7178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW15608
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: