Provider Demographics
NPI:1861645640
Name:KEAHON, JEANNE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:M
Last Name:KEAHON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JEANNE
Other - Middle Name:M
Other - Last Name:KEAHON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:27 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:TREADWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13846-4606
Mailing Address - Country:US
Mailing Address - Phone:607-829-8329
Mailing Address - Fax:
Practice Address - Street 1:27 CHURCH ST
Practice Address - Street 2:
Practice Address - City:TREADWELL
Practice Address - State:NY
Practice Address - Zip Code:13846
Practice Address - Country:US
Practice Address - Phone:607-829-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080780-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical