Keenan, Mary Bridget
Keenan, Mary Bridget is an individual health care provider with primary practice located at 150 N Main St Suite 130, Manchester CT 06042-2086. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Keenan, Mary Bridget can be contacted via phone (860) 533-3434.Contact Information
Primary practice address
150 N Main St Suite 130
Manchester CT 06042-2086
Phone: (860) 533-3434
Fax: (860) 647-6829
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 004136 | Connecticut |
Profile Details
| NPI number | 1063477719 |
|---|---|
| LBN Legal business name | Keenan, Mary Bridget |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 18th, 2006 |
| Last updated | Dec 11th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063477719 | NPPES |
| Connecticut | MEDICAID | 004025177 |
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