NPIMap

Individual provider Active NPI

Cynthia A. Keenan, PH.D. L.C.M.H.C.

  • Psychologist
  • Portsmouth, NH
National Provider Identifier
1497847156
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
31 Raynes Ave
Suite # 200
Portsmouth, NH 03801-3756
Phone
(603) 433-6777
Fax
(603) 433-6778
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 435 NH
School Psychologist 103TS0200X 79885 NH
Psychologist 103T00000X Primary
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Adult Development & Aging Psychologist 103TA0700X
Clinical Child & Adolescent Psychologist 103TC2200X
Cognitive & Behavioral Psychologist 103TB0200X
Family Psychologist 103TF0000X
Group Psychotherapy Psychologist 103TP2701X
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Clinical Neuropsychologist 103G00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X
Marriage & Family Therapist 106H00000X
Counseling Psychologist 103TC1900X

Addresses

Primary practice location

31 Raynes Ave
Suite # 200
Portsmouth, NH 03801-3756

Mailing address

31 Raynes Ave
Suite # 200
Portsmouth, NH 03801-3756
Phone (603) 433-6777

Other identifiers 1

IdentifierTypeStateIssuer
11626483OtherNHCAQH PROVIDER ID

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
435NHMDMental Health Counselor
79885NHMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
NPSS -Neuropsychological & Psychological Services for the Seacoast, PL Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1497847156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 RAYNES AVE",
            "address_2": "SUITE # 200",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038013756",
            "telephone_number": "603-433-6777",
            "fax_number": "603-433-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 RAYNES AVE",
            "address_2": "SUITE # 200",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038013756",
            "telephone_number": "603-433-6777",
            "fax_number": "603-433-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "CYNTHIA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.     L.C.M.H.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "435",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NH",
            "license": "79885",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11626483",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.