Provider Demographics
NPI:1538299045
Name:KEENAN, ANNE A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:A
Last Name:KEENAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 LANDS END NORTH POINT
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802
Mailing Address - Country:US
Mailing Address - Phone:479-890-5225
Mailing Address - Fax:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical