Provider Demographics
NPI:1245790088
Name:BARBARA JEAN KEANE, M.S.W., L.C.SW.
Entity Type:Organization
Organization Name:BARBARA JEAN KEANE, M.S.W., L.C.SW.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL/ SOCIAL WORKER/ P
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEANE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:923-831-8690
Mailing Address - Street 1:1103 COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1009
Mailing Address - Country:US
Mailing Address - Phone:973-831-8690
Mailing Address - Fax:973-831-4350
Practice Address - Street 1:1103 COLFAX AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1009
Practice Address - Country:US
Practice Address - Phone:973-831-8690
Practice Address - Fax:973-831-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty