Provider Demographics
NPI:1043594831
Name:O'KEEFE, MARISA GIULIANI (MA, ED S, MFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:GIULIANI
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:MA, ED S, MFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2426
Mailing Address - Country:US
Mailing Address - Phone:973-980-1634
Mailing Address - Fax:
Practice Address - Street 1:280 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2426
Practice Address - Country:US
Practice Address - Phone:973-980-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3TP11-017106H00000X
NJ37PC00470700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist