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General NPI Number Information
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NPI Number | 1932423217
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Entity Type | Organization
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Legal Business Name | ROBERT O'KEEFE LCSW LLC
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Dates
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Enumeration Date | 03/16/2010
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 72 PARK LANE RD
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City | NEW MILFORD
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State | CT
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Zip | 06776-2325
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Country | US
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Telephone | 860-355-0695
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | NEW MILFORD
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State | CT
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Zip | 06776-0247
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Country | US
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Telephone | 860-355-0695
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT EDWARD O'KEEFE
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Credential | LCSW
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Telephone | 860-355-0695
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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 | 001605
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License Number State | CT
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