Provider Demographics
NPI:1588834592
Name:KEENAN, SHEILA ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:KEENAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 NE 1ST ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3056
Mailing Address - Country:US
Mailing Address - Phone:425-453-7890
Mailing Address - Fax:877-879-3041
Practice Address - Street 1:11911 NE 1ST ST STE 206
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3056
Practice Address - Country:US
Practice Address - Phone:425-453-7890
Practice Address - Fax:877-879-3041
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000048531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical