Healthcare Provider Details

I. General information

NPI: 1962025601
Provider Name (Legal Business Name): E KEENEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 LAKEVIEW DR
WEST MILFORD NJ
07480-4279
US

IV. Provider business mailing address

43 LAKEVIEW DR
WEST MILFORD NJ
07480-4279
US

V. Phone/Fax

Practice location:
  • Phone: 201-370-7644
  • Fax:
Mailing address:
  • Phone: 201-370-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ELISABETH M KEENEY
Title or Position: OWNER, PSYCHOTHERAPIST
Credential: LPC
Phone: 201-370-7644