Micah T Keaney, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-1810 Issued in HI

Practice address

755 Scott Cir
Hickam Afb, HI 96853-5399

Phone

(808) 448-6377

NPI assigned

Jan 23, 2020

Sex

Male

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1457981060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "HICKAM AFB",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "HICKAM AFB",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Kunsan AB",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "962640011",
            "country_code": "US",
            "telephone_number": "808-554-3903",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "2146 Awikiwiki St",
            "address_purpose": "LOCATION",
            "city": "Pearl City",
            "state": "HI",
            "postal_code": "967821321",
            "country_code": "US",
            "telephone_number": "808-554-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEANEY",
        "first_name": "MICAH",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-23",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Hetue, PHARMD
• Hickam Afb 15TH MDG
• Hickam Phcy
• Michael Johnson Hsu, PHARM D
• Yvonne M Johnson, PA
• John Hankil Kim, D.O.
• Melissa Sue Kruse, DDS
• Betsy Ann Lefebvre, DDS
• Jeffery Michael Lerma, PA-C
• Khara Maciel, RDH

• Clinical Psychologist in Hickam Afb, HI
• Providers in Hickam Afb, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.