Provider Demographics
NPI:1497847156
Name:KEENAN, CYNTHIA A (PHD LCMHC)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:KEENAN
Suffix:
Gender:F
Credentials:PHD LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 RAYNES AVE
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-3756
Mailing Address - Country:US
Mailing Address - Phone:603-433-6777
Mailing Address - Fax:603-433-6778
Practice Address - Street 1:31 RAYNES AVE
Practice Address - Street 2:SUITE # 200
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3756
Practice Address - Country:US
Practice Address - Phone:603-433-6777
Practice Address - Fax:603-433-6778
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH435101YM0800X
NH79885103TS0200X
103T00000X, 103TA0400X, 103TA0700X, 103TC2200X, 103TB0200X, 103TF0000X, 103TP2701X, 103TM1800X, 103G00000X, 101YA0400X, 101YP2500X, 106H00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH11626483OtherCAQH PROVIDER ID