Healthcare Provider Details

I. General information

NPI: 1033003306
Provider Name (Legal Business Name): KEENAN DEENE TWOHIG MA, NCC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N GLEBE RD STE 104
ARLINGTON VA
22203-3755
US

IV. Provider business mailing address

304 ROANOKE DR SE
LEESBURG VA
20175-4005
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax:
Mailing address:
  • Phone: 978-489-8564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701014922
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: