Keenan, James W

Keenan, James W is an individual health care provider with primary practice located at 820 Lilac Dr N Suite 130, Golden Valley MN 55422-4700. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Keenan, James W can be contacted via phone (612) 874-6746.

Contact Information

Primary practice address
820 Lilac Dr N Suite 130 Golden Valley MN 55422-4700
Phone: (612) 874-6746
Fax: (612) 874-6745
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X LP3544 Minnesota
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X LP3544 Minnesota

Profile Details

NPI number 1710147418
LBN Legal business name Keenan, James W
Credentials MS, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2008
Last updated Sep 8th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710147418 NPPES
Minnesota Other 26A04KE BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 118817800 BLUE CROSS BLUE SHIELD

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