Mary Bridget Keenan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004136 Issued in CT

Practice address

150 N Main St
Suite 130
Manchester, CT 06042-2086

Phone

(860) 533-3434

Fax

(860) 647-6829

NPI assigned

Apr 18, 2006

Last updated

Dec 11, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prospect Manchester Hospital IncGroup PAC ID 9234423625, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prospect Manchester Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1316394638
  Medicare reassignment Care Compare group
• Manchester Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1881564664
  Medicare reassignment
• Prospect Rockville Hospital, Inc.

  • General Acute Care Hospital
  • Vernon, CT
  • NPI 1205283538
  Medicare reassignment
• Prospect Manchester Hospital, Inc.

  • Psychiatric Hospital Unit
  • Manchester, CT
  • NPI 1225484751

  Clinical

  NPD
• Eastern Connecticut Medical Professionals Foundation Inc

  dba Eastern CT Medical Professionals

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1770557712

  Clinical

  NPD (past)
• Eastern Connecticut Medical Professionals Foundation, Inc

  dba Eastern Orthopeadics and Sports Medicine, PC

  • Specialist
  • South Windsor, CT
  • NPI 1497864516
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1063477719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "address_2": "MANCHESTER MEMORIAL HOSPITAL",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-647-6832",
            "fax_number": "860-647-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MAIN ST",
            "address_2": "SUITE 130",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422086",
            "telephone_number": "860-533-3434",
            "fax_number": "860-647-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "MARY",
        "middle_name": "BRIDGET",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004025177",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gurpeet Kaur
• Manpreet Kaur, MD
• Alexandra Charlotte Kayat, PA
• Mary Ellen Keating
• Karen M Keefe Colt, LADC
• Martin Mark Keibel
• Bridget Keleher
• Kyla Q Kelley, LMSW
• Lisa Kelley, CNM
• Eric Kelly

• Clinical Social Worker in Manchester, CT
• Providers in Manchester, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.