Active NPI
Joyce B Keohan, LICSW
- Clinical Social Worker
- Kingston, MA
National Provider Identifier
1174539902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 105902
- Practice address
- 62 Main St
Kingston, MA 02364-3046 - Phone
- (781) 585-9300
- Fax
- (781) 585-9302
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 105902 | MA | Primary |
Addresses
Primary practice location
62 Main St
Kingston, MA 02364-3046
Mailing address
62 Main St
Kingston, MA 02364-3046
Phone (781) 585-9300
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 228395 | Other | MA | MHN/CHAMPUS |
| 800012152 | Other | MA | RAILROAD MEDICARE |
| 164420000 | Other | MA | MAGELLAN |
| 2099770 | Other | MA | CIGNA |
| 426056 | Other | MA | HARVARD/PILGRIM |
| PO44O8 | Other | MA | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
62 Main St
Suite 206
Kingston, MA 02364-3071
Phone (781) 585-9300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Mental Health Center, Inc. | Current | Accepting new patients | |
| Bridgewater Square Chiropractic Inc. | Past | Accepting new patients |
Locations
1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709
64 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 747-2012
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Quincy, MA
- NPI 1770528317
-
- Clinic/Center
- Bridgewater, MA
- NPI 1952422701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428019200000",
"number": "1174539902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 MAIN ST",
"city": "KINGSTON",
"state": "MA",
"postal_code": "023643046",
"telephone_number": "781-585-9300",
"fax_number": "781-585-9302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 MAIN ST",
"city": "KINGSTON",
"state": "MA",
"postal_code": "023643046",
"telephone_number": "781-585-9300",
"fax_number": "781-585-9302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOHAN",
"first_name": "JOYCE",
"middle_name": "B",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2015-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "105902",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN/CHAMPUS",
"identifier": "228395",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "800012152",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "164420000",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2099770",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD/PILGRIM",
"identifier": "426056",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "PO44O8",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kingston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.