MEDICARE: MS. GLENNA MARIE O'KEEFE LCSW-R

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R-054878	NY

General Provider Information

NPI Number	:	1437246964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GLENNA MARIE O'KEEFE LCSW-R

Provider Business Mailing Address
First Line	:	235 SEAMAN AVE
Second Line	:	6G
City	:	NEW YORK
State	:	NY
Zip	:	10034-1225
Country	:	US
Telephone Number	:	212-304-4721
Fax Number	:	212-425-3016

Provider Business Practice Location Address
First Line	:	1051 RIVERSIDE DR
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1007
Country	:	US
Telephone Number	:	347-514-1974
Fax Number	:	646-774-8572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	01/03/2025

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