Healthcare Provider Details

I. General information

NPI: 1881734309
Provider Name (Legal Business Name): CHRISTINE M KEUNEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 WILLARD AVE #233
CHEVY CHASE MD
20815
US

IV. Provider business mailing address

6650 32ND PL NW CHRISTINE M KEUNEN LCSW
WASHINGTON DC
20015
US

V. Phone/Fax

Practice location:
  • Phone: 202-244-8691
  • Fax:
Mailing address:
  • Phone: 202-244-8691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number03373
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC300882
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: