Provider Demographics
NPI:1407009954
Name:ANNE KEENAN LCSW AND ASSOCIATES
Entity Type:Organization
Organization Name:ANNE KEENAN LCSW AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:479-967-4443
Mailing Address - Street 1:2621 W MAIN ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-2534
Mailing Address - Country:US
Mailing Address - Phone:479-967-4443
Mailing Address - Fax:479-967-9344
Practice Address - Street 1:2621 W MAIN ST
Practice Address - Street 2:SUITE 7
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-2534
Practice Address - Country:US
Practice Address - Phone:479-967-4443
Practice Address - Fax:479-967-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1929 C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health