Provider Demographics
NPI:1134188410
Name:KEELER, BARBARA ALLEN
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ALLEN
Last Name:KEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PLUMMER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-1901
Mailing Address - Country:US
Mailing Address - Phone:978-465-6585
Mailing Address - Fax:978-465-9498
Practice Address - Street 1:1 MERRIMAC ST
Practice Address - Street 2:SUITE 17
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2558
Practice Address - Country:US
Practice Address - Phone:978-465-6585
Practice Address - Fax:978-465-9498
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1031271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA103127OtherTUFTS ID
MA143776000OtherAETNA ID
NH14Y001640MA01OtherANTHEM BLUE CROSS/BLUE SH
MAPO2615OtherBLUE CROSS/BLUE SHIELD
MA1853457Medicaid
MA143776000OtherMBH ID
MA550010005745OtherPACIFICARE ID
MA550010005745OtherPACIFICARE ID