Provider Demographics
NPI:1881018992
Name:CHRISTINA KEENAN LPC LLC
Entity Type:Organization
Organization Name:CHRISTINA KEENAN LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-417-6426
Mailing Address - Street 1:221 DANBURY RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-4354
Mailing Address - Country:US
Mailing Address - Phone:203-417-6426
Mailing Address - Fax:860-797-2431
Practice Address - Street 1:221 DANBURY RD
Practice Address - Street 2:SUITE H
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-4354
Practice Address - Country:US
Practice Address - Phone:203-417-6426
Practice Address - Fax:860-797-2431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001198251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health