Provider Demographics
NPI:1346579745
Name:KATHLEEN J. KEENAN, PH.D., L.L.C.
Entity Type:Organization
Organization Name:KATHLEEN J. KEENAN, PH.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:913-648-1870
Mailing Address - Street 1:10965 GRANADA LANE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1412
Mailing Address - Country:US
Mailing Address - Phone:913-777-6665
Mailing Address - Fax:913-345-0090
Practice Address - Street 1:10965 GRANADA LANE
Practice Address - Street 2:SUITE 101
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1412
Practice Address - Country:US
Practice Address - Phone:913-777-6665
Practice Address - Fax:913-345-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS994103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0008125AMedicare PIN