Provider Demographics
NPI:1982770475
Name:MCKEOWN, EILEEN ANNE (PHD, CSW)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:ANNE
Last Name:MCKEOWN
Suffix:
Gender:F
Credentials:PHD, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6350
Mailing Address - Country:US
Mailing Address - Phone:631-427-5294
Mailing Address - Fax:
Practice Address - Street 1:214 W 22ND ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6350
Practice Address - Country:US
Practice Address - Phone:631-427-5294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0496301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical