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NPI Code Detail

MEDICARE: JENNIFER KEANE LMSW

MEDICARE: JENNIFER KEANE LMSW
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
11041C0700XClinical Social Worker06889KS

General Provider Information

NPI Number : 1942495742
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KEANE LMSW
Provider Business Mailing Address
First Line : 1521 S SEDGWICK ST
Second Line :
City : WICHITA
State : KS
Zip : 67213-2920
Country : US
Telephone Number : 316-413-1534
Fax Number : 833-485-5149
Provider Business Practice Location Address
First Line : 1521 S SEDGWICK ST
Second Line :
City : WICHITA
State : KS
Zip : 67213-2920
Country : US
Telephone Number : 316-413-1534
Fax Number : 833-485-5149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2007
Last Update Date : 05/06/2026

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