Healthcare Provider Details

I. General information

NPI: 1336472455
Provider Name (Legal Business Name): STEPHANIE CLAIRE KEATING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTER RD
WEST SENECA NY
14224-1946
US

IV. Provider business mailing address

300 CENTER RD
WEST SENECA NY
14224-1946
US

V. Phone/Fax

Practice location:
  • Phone: 716-209-3161
  • Fax: 716-677-0230
Mailing address:
  • Phone: 716-209-3161
  • Fax: 716-677-0230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number082689-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: