Keane, John
Keane, John is an individual health care provider with primary practice located at 402 E Main St Waterbury Op Adult Services, Waterbury CT 06702-1701. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Keane, John can be contacted via phone (203) 755-1143.Contact Information
Primary practice address
402 E Main St Waterbury Op Adult Services
Waterbury CT 06702-1701
Phone: (203) 755-1143
Fax: (203) 755-1447
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | ||
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 2166 | Connecticut |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
| NPI number | 1679900765 |
|---|---|
| LBN Legal business name | Keane, John |
| Credentials | LMSW,BA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2013 |
| Last updated | Jun 2nd, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679900765 | NPPES |
| Connecticut | Other | PENDING | AETNA BEHAVIORAL HEALTH |
| Connecticut | MEDICAID | 008064408 | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | 060669107 | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | 060669107 | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | NOT ELIGIBLE | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | 060669107 | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | 060669107 | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | PENDING | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | 13671836 | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | D339123 WATERBURY | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | NOT ELIGIBLE | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | 060669107 | AETNA BEHAVIORAL HEALTH |
| Connecticut | Other | 060669107 | AETNA BEHAVIORAL HEALTH |
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