MEDICARE: E KEENEY LLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1962025601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E KEENEY LLC

Provider Business Mailing Address
First Line	:	43 LAKEVIEW DR
Second Line	:
City	:	WEST MILFORD
State	:	NJ
Zip	:	07480-4279
Country	:	US
Telephone Number	:	201-370-7644
Fax Number	:

Provider Business Practice Location Address
First Line	:	43 LAKEVIEW DR
Second Line	:
City	:	WEST MILFORD
State	:	NJ
Zip	:	07480-4279
Country	:	US
Telephone Number	:	201-370-7644
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PSYCHOTHERAPIST
Name	:	MS. ELISABETH M KEENEY
Credential	:	LPC
Telephone Number	:	201-370-7644

Provider Enumeration Date	:	05/28/2020
Last Update Date	:	05/28/2020

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