Active NPI
Mary Theresa Keane, LCSW-C
- Clinical Social Worker
- Columbia, MD
National Provider Identifier
1043437288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 05924
- Practice address
- 9810 Patuxent Woods Dr Ste C
Columbia, MD 21046-1595 - Phone
- (410) 290-6432
- Fax
- (410) 290-6604
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 05924 | MD | Primary |
Addresses
Primary practice location
9810 Patuxent Woods Dr Ste C
Columbia, MD 21046-1595
Mailing address
6148 Waiting SPG
Columbia, MD 21045-4044
Phone (410) 730-2889
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R980-0003 | Other | MD | BCBS NATL CAPITOL AREA |
| 718102-01 | Other | MD | CAREFIRST BCBSOF MD |
Other names 1
- M. Theresa Keane
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sttar Center Inc | Clinical | Past | Accepting new patients |
| Kennedy Krieger Children'S Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental Disabilities Clinic/Center
- Fulton, MD
- NPI 1932917085
-
- Clinical Social Worker
- Columbia, MD
- NPI 1093832180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043437288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6148 WAITING SPG",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454044",
"telephone_number": "410-730-2889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9810 PATUXENT WOODS DR STE C",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210461595",
"telephone_number": "410-290-6432",
"fax_number": "410-290-6604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEANE",
"first_name": "MARY",
"middle_name": "THERESA",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "05924",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NATL CAPITOL AREA",
"identifier": "R980-0003",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBSOF MD",
"identifier": "718102-01",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "M.",
"last_name": "KEANE",
"middle_name": "THERESA",
"credential": "LCSW-C",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.