1437246964 NPI number — MS. GLENNA MARIE O'KEEFE LCSW-R

Table of content: MS. GLENNA MARIE O'KEEFE LCSW-R (NPI 1437246964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437246964 NPI number — MS. GLENNA MARIE O'KEEFE LCSW-R

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'KEEFE
Provider First Name:
GLENNA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW-R
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437246964
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 SEAMAN AVE
Provider Second Line Business Mailing Address:
6G
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10034-1225
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-304-4721
Provider Business Mailing Address Fax Number:
212-425-3016

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1051 RIVERSIDE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032-1007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-514-1974
Provider Business Practice Location Address Fax Number:
646-774-8572
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R-054878 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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