Provider Demographics
NPI:1104541267
Name:KEELEY, CARRIE LYN
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYN
Last Name:KEELEY
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 1:219 DEARBORN RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NH
Mailing Address - Zip Code:03275-1349
Mailing Address - Country:US
Mailing Address - Phone:603-370-2520
Mailing Address - Fax:
Practice Address - Street 1:219 DEARBORN RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NH
Practice Address - Zip Code:03275-1349
Practice Address - Country:US
Practice Address - Phone:603-370-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker