Provider Demographics
NPI:1174053961
Name:KEEHN, JENNIFER MARIE (MA, LPCC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARIE
Last Name:KEEHN
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 BIELENBERG DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4416
Mailing Address - Country:US
Mailing Address - Phone:651-313-8080
Mailing Address - Fax:651-925-0610
Practice Address - Street 1:659 BIELENBERG DR STE 200
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1717
Practice Address - Country:US
Practice Address - Phone:651-259-9700
Practice Address - Fax:651-259-9780
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty