Patricia Marie Keohane, LMHC

Individual provider Active NPI Mental Health Counselor · Vineyard Haven, MA

NPI 1861676926 · NPPES record last updated Jun 14, 2016

Key facts

NPI
1861676926
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
7688 (MA)
Practice address
15 Church St
Vineyard Haven, MA 02568-5483
Phone
(508) 627-2843
Fax
(508) 693-2198
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

52 Robinson Rd
Falmouth, MA 02540-3841
Phone (508) 627-2843

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240320002417 MA Practitioner - Mental Health Counselor 8527418649 Practice locations: Falmouth, MA

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
7688MAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7688 MA Yes

Addresses

Primary practice location

15 Church St
Vineyard Haven, MA 02568-5483

Mailing address

PO Box 1003
West Tisbury, MA 02575-1003
Phone (508) 627-2843

Other providers in Vineyard Haven, MA

All providers in Vineyard Haven, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.