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General NPI Number Information
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NPI Number | 1881018992
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Entity Type | Organization
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Legal Business Name | CHRISTINA KEENAN LPC LLC
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 221 DANBURY RD SUITE H
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City | NEW MILFORD
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State | CT
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Zip | 06776-4354
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Country | US
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Telephone | 203-417-6426
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Fax | 860-797-2431
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Provider Business Mailing Address
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Address Line | 221 DANBURY RD SUITE H
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City | NEW MILFORD
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State | CT
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Zip | 06776-4354
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Country | US
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Telephone | 203-417-6426
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Fax | 860-797-2431
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CHRISTINA MARIE KEENAN
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Credential | LPC
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Telephone | 203-417-6426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001198
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License Number State | CT
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