Provider Demographics
NPI:1124389630
Name:KEATING, DEVRA (LMSW)
Entity Type:Individual
Prefix:
First Name:DEVRA
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 E 32ND ST
Mailing Address - Street 2:10TH FLOOR, THE RENFREW CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-685-6856
Mailing Address - Fax:
Practice Address - Street 1:38 E 32ND ST
Practice Address - Street 2:10TH FLOOR, THE RENFREW CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-685-6856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088343-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical