Provider Demographics
NPI:1538288527
Name:KEENAN, EDWARD FRANCIS (MSW)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:FRANCIS
Last Name:KEENAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SASSAFRAS TRL
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-2503
Mailing Address - Country:US
Mailing Address - Phone:401-782-8276
Mailing Address - Fax:
Practice Address - Street 1:50A OFFICE PKWY
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1636
Practice Address - Country:US
Practice Address - Phone:401-434-0913
Practice Address - Fax:401-434-2086
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW006741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical