Lucille Baker Keenan, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4036 Issued in NC

Practice address

213 Woodburn Rd
Raleigh, NC 27605-1618

Phone

(919) 604-7401

NPI assigned

Sep 25, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1346490463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 WOODBURN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051618",
            "telephone_number": "919-604-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 WOODBURN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051618",
            "telephone_number": "919-604-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "629 Oberlin Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276051126",
            "country_code": "US",
            "telephone_number": "919-604-7401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "LUCILLE",
        "middle_name": "BAKER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Keegan, LMBT
• Jill Hinton Keel, PH.D.
• Keen Eye Chiropractic PLLC
• Crystal Renee Keen, ANP
• Christine Elizabeth Keenan, FNP-C
• Michael Graham Keene, PA-C
• Whitney Joyner Keene, OTR/L
• Joseph Keith Keener, M.D.
• Keep Counsel
• Keeping It Moving, LLC

• Clinical Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.