Individual provider Active NPI

Mary Kathleen O'Keeffe, MA, LMFT

  • Marriage & Family Therapist
  • Kingsport, TN
National Provider Identifier
1356372007
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMT223 Issued in TN
Practice address
1570 Waverly Rd
Kingsport, TN 37664-2523
Phone
(423) 224-1300
Fax
(423) 467-3644
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMT223 TN Primary

Addresses

Primary practice location

1570 Waverly Rd
Kingsport, TN 37664-2523

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600

Other identifiers 2

IdentifierTypeStateIssuer
5441098MedicaidTN
444006MedicaidVA

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LMT223TNMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1356372007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 WAVERLY RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642523",
            "telephone_number": "423-224-1300",
            "fax_number": "423-467-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFFE",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "LMT223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5441098",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444006",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.