Odetta Keane

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R063573-1 Issued in NY

Practice address

320 Franklin Ave
Brooklyn, NY 11238

Phone

(191) 758-9034

NPI assigned

Aug 18, 2015

Sex

Female

Sole proprietor

Yes

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 NY

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens Psychotherapy LCSW Services P.C.Group PAC ID 9931499639, 14 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 and National Provider Directory roles.

• Queens Psychotherapy LCSW Services P.C.

  • Clinical Social Worker
  • Rego Park, NY
  • NPI 1366806705
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1881060531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 FRANKLIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381470",
            "telephone_number": "191-758-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 FRANKLIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11238",
            "telephone_number": "191-758-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "ODETTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R063573-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KCL Therapeutic Services, LLC
• Brian Keag
• Carissa Lorrin Kealy, PSYD
• Monet Keane-Dawes, PTA
• Sybrina Keane-Negri, CCC-SLP
• Keap Drugs Inc.
• Jeffrey Alan Kearn
• Angela C Kearney, MH LIMITED PERMIT
• Debra J Kearse-Thomas, LCSW
• Kelly Maureen Keating, MD

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.