Provider Demographics
NPI:1578659215
Name:O'KEEFE, KATHLEEN VERONICA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:VERONICA
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16331 DRAGONNADE TRAIL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-379-7494
Mailing Address - Fax:804-272-1683
Practice Address - Street 1:4920 E. MILLRIDGE PARKWAY
Practice Address - Street 2:SUITE 206
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:804-928-4632
Practice Address - Fax:804-272-1683
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA09040043651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0007759577OtherAETNA
VA11526990OtherCAQH
AL087086MOtherSENTARA
VA461826OtherANTHEM BC/BS
VA214922OtherCOMPSYCH