Active NPI
Kathleen Ann Keegan, LICSW
- Clinical Social Worker
- Beverly, MA
National Provider Identifier
1205994233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 105614
- Practice address
- 900 Cummings CT
Suite 412U
Beverly, MA 01915 - Phone
- (978) 927-9792
- Fax
- (978) 998-6784
- NPI assigned
- Dec 4, 2006
- 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 | 105614 | MA | Primary |
Addresses
Primary practice location
900 Cummings CT
Suite 412U
Beverly, MA 01915
Mailing address
900 Cummings Center
Suite 412U
Beverly, MA 01915
Phone (978) 927-9792
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1892118 | Medicaid | MA |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051031000246 | MA | Practitioner - Clinical Social Worker | 4183641079 | Practice locations: Beverly, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
900 Cummings Ctr
Suite 214U
Beverly, MA 01915-6182
Phone 978998678213
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105614 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205994233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 CUMMINGS CENTER",
"address_2": "SUITE 412U",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-927-9792",
"fax_number": "978-998-6784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 CUMMINGS CT",
"address_2": "SUITE 412U",
"city": "BEVERLY",
"state": "MA",
"postal_code": "01915",
"telephone_number": "978-927-9792",
"fax_number": "978-998-6784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEGAN",
"first_name": "KATHLEEN",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "105614",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1892118",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly, MA
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.
- 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.