Provider Demographics
NPI:1376148189
Name:KEANE, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:KEANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:ENDSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 EDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1282
Mailing Address - Country:US
Mailing Address - Phone:716-479-2862
Mailing Address - Fax:
Practice Address - Street 1:29 EDGEWATER LN
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1282
Practice Address - Country:US
Practice Address - Phone:716-479-2862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health