Andrew Jay Keough, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4601-C Issued in AR

Practice address

1502 Mary Kay Blvd
Benton, AR 72015-7201

Phone

(501) 315-3344

NPI assigned

Nov 3, 2009

Last updated

Jan 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Birch Tree Communities IncGroup PAC ID 5597749747, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Birch Tree Communities Inc

  dba Conway Branch

  • Community/Behavioral Health Agency
  • Conway, AR
  • NPI 1770733768
  Medicare reassignment Care Compare group NPD
• Birch Tree Communities, Inc

  dba Malvern Branch

  • Community/Behavioral Health Agency
  • Malvern, AR
  • NPI 1316197304
  NPD
• Birch Tree Communities, Inc

  dba Clinton Branch

  • Community/Behavioral Health Agency
  • Clinton, AR
  • NPI 1629228606
  NPD
• Lead, Teach, Mentor LLC

  dba Thriveworks Conway

  • Community/Behavioral Health Agency
  • Conway, AR
  • NPI 1497167548
  NPD (past)

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

{
    "created_epoch": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1851628481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1589",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720181589",
            "telephone_number": "501-315-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 MARY KAY BLVD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720157201",
            "telephone_number": "501-315-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N University Ave",
            "address_2": "suite 200",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722076343",
            "country_code": "US",
            "telephone_number": "501-686-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEOUGH",
        "first_name": "ANDREW",
        "middle_name": "JAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "4601-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Kemper, LPC
• Andrea Michele Kendrick, PHARM D
• Alana Kennedy
• Rebekah Anne Kennedy
• Kenneth D Wright, MD
• Paula Kathryn Keys, OTR
• Crystal Kidd
• David Kidd
• Janey Kidd
• Kidsource Therapy

• Clinical Social Worker in Benton, AR
• Providers in Benton, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.