Provider Demographics
NPI:1801068812
Name:KEENEY, DEBORAH SIMS (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:SIMS
Last Name:KEENEY
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-6533
Mailing Address - Country:US
Mailing Address - Phone:510-326-9300
Mailing Address - Fax:530-653-2228
Practice Address - Street 1:412 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-6533
Practice Address - Country:US
Practice Address - Phone:510-326-9300
Practice Address - Fax:530-653-2228
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45394106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist