MEDICARE: KERI KEENAN

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

General Provider Information

NPI Number	:	1831937820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI KEENAN

Provider Business Mailing Address
First Line	:	300 OXFORD DR STE 50
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-2343
Country	:	US
Telephone Number	:	412-728-5904
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 OXFORD DR STE 50
Second Line	:
City	:	MONROEVILLE
State	:	PA
Zip	:	15146-2343
Country	:	US
Telephone Number	:	412-728-5904
Fax Number	:

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

Provider Enumeration Date	:	07/16/2024
Last Update Date	:	07/16/2024

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