Healthcare Provider Details

I. General information

NPI: 1629552807
Provider Name (Legal Business Name): DEANNA JC O'KEEFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CUMMINGS CTR STE 364U
BEVERLY MA
01915-6174
US

IV. Provider business mailing address

PO BOX 4092
PEABODY MA
01961-4092
US

V. Phone/Fax

Practice location:
  • Phone: 978-992-3648
  • Fax:
Mailing address:
  • Phone: 781-718-3787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1140653
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: