Provider Demographics
NPI:1265594204
Name:KEEGAN, JUDITH SHARON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:SHARON
Last Name:KEEGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 US HIGHWAY 202
Mailing Address - Street 2:SUITE B-9
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1475
Mailing Address - Country:US
Mailing Address - Phone:908-526-7771
Mailing Address - Fax:
Practice Address - Street 1:1124 US HIGHWAY 202
Practice Address - Street 2:SUITE B-9
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1475
Practice Address - Country:US
Practice Address - Phone:908-526-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046227001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical