Physician Compare National (NPI:1427190099)

HEALTHCARE PROVIDER: LUANN KEENER-MIKENAS LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1427190099
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840243820
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050302000410
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KEENER-MIKENAS
	Individual professional last name
Provider First Name	LUANN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	CSW
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	311 RIVERMONT AVE
	Group Practice or individual's line 1 address
City	LYNCHBURG
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	245042336
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4342210778
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y