Diana Keenan, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0134284 Issued in VT

Practice address

125 Saint Paul St Ste 106
Burlington, VT 05401-8462

Phone

(845) 300-5861

NPI assigned

Jun 3, 2020

Last updated

Nov 27, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: No
• 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vermont Wellness Collaborative Inc

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1134830409
  Medicare reassignment NPD
• Wildflower Counseling & Consulting LLC

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1649066465
  Authorized official Same address or phone

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1376167528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SAINT PAUL ST STE 106",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SAINT PAUL ST STE 106",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018462",
            "telephone_number": "845-300-5861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1138 Pine St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054015353",
            "country_code": "US",
            "telephone_number": "802-488-6000",
            "fax_number": "802-488-6919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "DIANA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0134284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.vermontwellness.org",
            "affiliation": "Y",
            "endpointDescription": "Webiste",
            "address_1": "125 Saint Paul St Ste 106",
            "city": "Burlington",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054018462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Kathleen Kearney, PA C
• Meghan Kearns, LCMHC
• David P Keating, MD
• Friederike Kyra Keating, MD
• Kathleen M Keating, APRN
• Kristopher Keeton, DDS
• Robert Lewis Keith, PH.D.
• William A. Keithcart, MA, LADC
• Julie Anne Kelbert, CRNA
• Erin Kellar, MS, AAP

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.