Provider Demographics
NPI:1871724682
Name:KEELER-LEBIEN, JULIET (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:JULIET
Middle Name:
Last Name:KEELER-LEBIEN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-2011
Mailing Address - Country:US
Mailing Address - Phone:917-679-2023
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1707
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6641
Practice Address - Country:US
Practice Address - Phone:917-679-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1072261041C0700X
NJ44SC060589001041C0700X
MA1186281041C0700X
AL5169C1041C0700X
NY076843-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical