Individual provider Active NPI

Thomas Patrick Keaveny, MSW LICSW

  • Clinical Social Worker
  • New Ulm, MN
National Provider Identifier
1821264854
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8900 Issued in MN
Practice address
1400 6TH Street North
New Ulm, MN 56073
Phone
(507) 359-2617
Fax
(507) 354-3667
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8900 MN Primary

Addresses

Primary practice location

1400 6TH Street North
New Ulm, MN 56073

Mailing address

1400 6TH Street North
New Ulm, MN 56073
Phone (507) 359-2617

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
8900MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1821264854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 6TH STREET NORTH",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "56073",
            "telephone_number": "507-359-2617",
            "fax_number": "507-354-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 6TH STREET NORTH",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "56073",
            "telephone_number": "507-359-2617",
            "fax_number": "507-354-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEAVENY",
        "first_name": "THOMAS",
        "middle_name": "PATRICK",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Ulm, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.