Active NPI
Paul R O'Keeffe, LCSW-C
- Clinical Social Worker
- Takoma Park, MD
National Provider Identifier
1659701027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 15054
- Practice address
- 7610 Carroll Ave
Suite 200
Takoma Park, MD 20912-6312 - Phone
- (301) 891-2077
- Fax
- (301) 891-2080
- NPI assigned
- Nov 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 15054 | MD | Primary |
Addresses
Primary practice location
7610 Carroll Ave
Suite 200
Takoma Park, MD 20912-6312
Mailing address
100 Arch St
Boston, MA 02110-1111
Phone (617) 542-2964
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116882 | Other | MA | LICSW LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15054 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Anthony Shrine | Clinical | 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.
-
- Clinical Social Worker
- Boston, MA
- NPI 1265804892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513555200000",
"number": "1659701027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 ARCH ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021101111",
"telephone_number": "617-542-2964",
"fax_number": "617-426-0860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7610 CARROLL AVE",
"address_2": "SUITE 200",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209126312",
"telephone_number": "301-891-2077",
"fax_number": "301-891-2080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'KEEFFE",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-20",
"last_updated": "2017-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "15054",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICSW LICENSE",
"identifier": "116882",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Takoma Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.