Active NPI
William Michael Keane, PH.D,
- Clinical Psychologist
- Watertown, MA
National Provider Identifier
1750455044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1976
- Practice address
- 17 Spring St
Watertown, MA 02472-3411 - Phone
- (617) 926-6664
- Fax
- (617) 522-0905
- NPI assigned
- Nov 20, 2006
- 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 Psychologist | 103TC0700X | 1976 | MA | Primary |
Addresses
Primary practice location
17 Spring St
Watertown, MA 02472-3411
Mailing address
17 Spring St
Watertown, MA 02472-3411
Phone (617) 926-6664
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750455044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 SPRING ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024723411",
"telephone_number": "617-926-6664",
"fax_number": "617-522-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 SPRING ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024723411",
"telephone_number": "617-926-6664",
"fax_number": "617-522-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEANE",
"first_name": "WILLIAM",
"middle_name": "MICHAEL",
"credential": "PH.D,",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "1976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.