Provider Demographics
NPI:1790213726
Name:KEOUGH, DOROTHY ELIZABETH (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ELIZABETH
Last Name:KEOUGH
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 TROY ST STE 4
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3023
Mailing Address - Country:US
Mailing Address - Phone:508-737-3106
Mailing Address - Fax:
Practice Address - Street 1:66 TROY ST STE 4
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3023
Practice Address - Country:US
Practice Address - Phone:508-737-3106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-04
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health