MEDICARE: JESSICA KEENEY LMHC

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	101YM0800X	Mental Health Counselor	017332	NY

General Provider Information

NPI Number	:	1497515258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA KEENEY LMHC

Provider Business Mailing Address
First Line	:	13318 87TH ST
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-1954
Country	:	US
Telephone Number	:	347-557-4707
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 DOBBIN ST STE 204A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11222-2803
Country	:	US
Telephone Number	:	347-255-7637
Fax Number	:

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

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	01/08/2026

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