Provider Demographics
NPI:1871707216
Name:KEELER, DANA CAMERON (LCSW)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:CAMERON
Last Name:KEELER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 E 11TH ST
Mailing Address - Street 2:SUITE 526
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6811
Mailing Address - Country:US
Mailing Address - Phone:212-505-5034
Mailing Address - Fax:212-420-0157
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:SUITE 526
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:212-505-5034
Practice Address - Fax:212-420-0157
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR045281-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical