Provider Demographics
NPI:1174066708
Name:MCKEOWN, KATHLEEN A
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:MCKEOWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ATWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-4266
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1287
Practice Address - Country:US
Practice Address - Phone:413-586-2973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health