Provider Demographics
NPI:1669728192
Name:KEENAN, MEGAN LAVIN (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LAVIN
Last Name:KEENAN
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 1:686 1ST AVENUE EAST N
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3706
Mailing Address - Country:US
Mailing Address - Phone:406-249-9017
Mailing Address - Fax:
Practice Address - Street 1:723 5TH AVE E STE 110C
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5325
Practice Address - Country:US
Practice Address - Phone:406-249-9017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker