Mary Claire Keenan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006360 Issued in CT

Practice address

30 Burcam Dr
Madison, CT 06443-2242

Phone

(203) 654-0840

Fax

(203) 654-0840

NPI assigned

Jan 2, 2007

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Yale New Haven Hospital

  • General Acute Care Hospital
  • New Haven, CT
  • NPI 1336139500
  Medicare reassignment

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1356408447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BURCAM DR",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432242",
            "telephone_number": "203-654-0840",
            "fax_number": "203-654-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BURCAM DR",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432242",
            "telephone_number": "203-654-0840",
            "fax_number": "203-654-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "MARY",
        "middle_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lara Jane Kaplan Goodrich, PHD
• David E Karas, MD
• Laura Jean Kasprow, LCSW
• KC Chiropractic
• Maryann Keating
• Susanne Kennedy
• Susan E Kenney, PT
• Kornelia Keszler, MD
• Julia King, PSY.D., MBA
• Marilyn Kirk, NBC-HWC

• Clinical Social Worker in Madison, CT
• Providers in Madison, 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 May 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.