MEDICARE: MRS. LYNN FRANCES KEOHANE LCSW

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	089739	NY
2	101YM0800X	Mental Health Counselor	089739	NY

General Provider Information

NPI Number	:	1538730049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNN FRANCES KEOHANE LCSW

Provider Business Mailing Address
First Line	:	8203 MAIN ST STE 2
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6051
Country	:	US
Telephone Number	:	716-880-7589
Fax Number	:

Provider Business Practice Location Address
First Line	:	8203 MAIN ST STE 2
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6051
Country	:	US
Telephone Number	:	716-880-7589
Fax Number	:

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

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	03/12/2025

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