Provider Demographics
NPI:1629222047
Name:KEELEY, PATRICK (LSW)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:KEELEY
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 COURT ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-1709
Mailing Address - Country:US
Mailing Address - Phone:732-780-7387
Mailing Address - Fax:732-780-5157
Practice Address - Street 1:37 COURT ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1709
Practice Address - Country:US
Practice Address - Phone:732-780-7387
Practice Address - Fax:732-780-5157
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL054839101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor