Provider Demographics
NPI:1841323623
Name:KEENAN, KEVIN FRANCIS (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:FRANCIS
Last Name:KEENAN
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 KIRK AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97327-2235
Mailing Address - Country:US
Mailing Address - Phone:541-466-3515
Mailing Address - Fax:541-928-1678
Practice Address - Street 1:425 2ND AVE SW
Practice Address - Street 2:SUITE 204
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2482
Practice Address - Country:US
Practice Address - Phone:541-401-0510
Practice Address - Fax:541-928-1678
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCO999101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional