Individual provider Active NPI

Colleen G Keegan

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1437875432
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC8202 Issued in ME
Practice address
11 Baxter Blvd FL 2
Portland, ME 04101-1801
Phone
(603) 883-0005
NPI assigned
Oct 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC8202 ME Primary

Addresses

Primary practice location

11 Baxter Blvd FL 2
Portland, ME 04101-1801

Mailing address

638 Congress St Apt 511
Portland, ME 04101-8343
Phone (207) 274-9270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC8202MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1437875432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 CONGRESS ST APT 511",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041018343",
            "telephone_number": "207-274-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BAXTER BLVD FL 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011801",
            "telephone_number": "603-883-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEGAN",
        "first_name": "COLLEEN",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC8202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.