Provider Demographics
NPI:1437246964
Name:O'KEEFE, GLENNA MARIE (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:GLENNA
Middle Name:MARIE
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 SEAMAN AVE
Mailing Address - Street 2:6G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1225
Mailing Address - Country:US
Mailing Address - Phone:212-304-4721
Mailing Address - Fax:212-425-3016
Practice Address - Street 1:19 W 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3006
Practice Address - Country:US
Practice Address - Phone:212-616-0905
Practice Address - Fax:212-425-3016
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0548781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical