Provider Demographics
NPI:1245982842
Name:O'KEEFE, THERESA (MS, MSW)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:MS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17669 CALAMITY LN
Mailing Address - Street 2:
Mailing Address - City:HUSON
Mailing Address - State:MT
Mailing Address - Zip Code:59846-9006
Mailing Address - Country:US
Mailing Address - Phone:406-304-1192
Mailing Address - Fax:
Practice Address - Street 1:113 W FRONT ST STE 109
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4327
Practice Address - Country:US
Practice Address - Phone:815-414-2741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT700861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical