Provider Demographics
NPI:1942869995
Name:KEENAN, BRITTANY (LSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:BYRAM TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-4012
Mailing Address - Country:US
Mailing Address - Phone:862-579-8941
Mailing Address - Fax:
Practice Address - Street 1:200 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3614
Practice Address - Country:US
Practice Address - Phone:973-229-3198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06177900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker