Provider Demographics
NPI:1073026001
Name:KEEN, CHRISTINA (LICSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KEEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 9TH ST NW STE 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3361
Mailing Address - Country:US
Mailing Address - Phone:571-418-1426
Mailing Address - Fax:
Practice Address - Street 1:1410 9TH ST NW STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3361
Practice Address - Country:US
Practice Address - Phone:571-418-1426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500813841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical