Provider Demographics
NPI:1518040153
Name:O'KEEFE, ANN MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BMC DORCHESTER DIVISION, COURT CLINIC
Mailing Address - Street 2:510 WASHINGTON ST
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124
Mailing Address - Country:US
Mailing Address - Phone:617-288-9500
Mailing Address - Fax:617-288-2360
Practice Address - Street 1:BMC DORCHESTER DIVISION, COURT CLINIC
Practice Address - Street 2:510 WASHINGTON ST
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124
Practice Address - Country:US
Practice Address - Phone:617-288-9500
Practice Address - Fax:617-288-2360
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10706103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical