James O'Keefe, LCSW

Individual provider Active NPI Clinical Social Worker · Tivoli, NY

NPI 1881708147 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1881708147
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R033495-1 (NY)
Practice address
6 Spring Street
Tivoli, NY 12583
Phone
(845) 757-5434
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
R033495-1NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R033495-1 NY Yes

Addresses

Primary practice location

6 Spring Street
Tivoli, NY 12583

Mailing address

PO Box 314
Tivoli, NY 12583-0314

Other identifiers

IdentifierTypeStateIssuer
01905357MedicaidNY

Other providers in Tivoli, NY

All providers in Tivoli, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.