Provider Demographics
NPI:1609816230
Name:KEENAN, ROBERTA (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6669 E 60TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-9207
Mailing Address - Country:US
Mailing Address - Phone:918-481-6899
Mailing Address - Fax:918-481-6899
Practice Address - Street 1:6669 E 60TH PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9207
Practice Address - Country:US
Practice Address - Phone:918-481-6899
Practice Address - Fax:918-481-6899
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK571106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist