Provider Demographics
NPI:1205647807
Name:KEEN, SARAH N
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:N
Last Name:KEEN
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 1:17206 BLANCO RD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2816
Mailing Address - Country:US
Mailing Address - Phone:210-209-0642
Mailing Address - Fax:855-357-8282
Practice Address - Street 1:17206 BLANCO RD BLDG 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2816
Practice Address - Country:US
Practice Address - Phone:210-209-0642
Practice Address - Fax:855-357-8282
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86360101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional