Active NPI
Alyssa E Keegan, LICSW
- Clinical Social Worker
- Lynn, MA
National Provider Identifier
1972525830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114126
- Practice address
- 111 North Carolina Street
Lynn, MA 01902 - Phone
- (781) 598-5517
- Fax
- (781) 581-6614
- NPI assigned
- Jul 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 212505 | MA | |
| Clinical Social Worker | 1041C0700X | 114126 | MA | Primary |
Addresses
Primary practice location
111 North Carolina Street
Lynn, MA 01902
Mailing address
40 R Prospect Street
Marblehead, MA 01945
Phone (781) 990-3221
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114126 | MA | MD | Clinical Social Worker |
| 212505 | MA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186704000000",
"number": "1972525830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 R PROSPECT STREET",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "01945",
"telephone_number": "781-990-3221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 NORTH CAROLINA STREET",
"city": "LYNN",
"state": "MA",
"postal_code": "01902",
"telephone_number": "781-598-5517",
"fax_number": "781-581-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEGAN",
"first_name": "ALYSSA",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-23",
"last_updated": "2007-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "212505",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "114126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.