Active NPI
Sean M Keane
- Clinical Social Worker
- Hartford, CT
National Provider Identifier
1760520506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5671
- Practice address
- 500 Vine Street
Capitol Region Mental Health Center
Hartford, CT 06112 - Phone
- (860) 297-0905
- Fax
- (860) 297-0914
- NPI assigned
- Feb 2, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 5671 | CT | Primary |
Addresses
Primary practice location
500 Vine Street
Capitol Region Mental Health Center
Hartford, CT 06112
Mailing address
500 Vine Street
Capitol Region Mental Health Center Co Human Resources
Hartford, CT 06112
Phone (860) 297-0905
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5671 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760520506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 VINE STREET",
"address_2": "CAPITOL REGION MENTAL HEALTH CENTER CO HUMAN RESOURCES",
"city": "HARTFORD",
"state": "CT",
"postal_code": "06112",
"telephone_number": "860-297-0905",
"fax_number": "860-297-0914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 VINE STREET",
"address_2": "CAPITOL REGION MENTAL HEALTH CENTER",
"city": "HARTFORD",
"state": "CT",
"postal_code": "06112",
"telephone_number": "860-297-0905",
"fax_number": "860-297-0914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEANE",
"first_name": "SEAN",
"middle_name": "M",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "5671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
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.