Provider Demographics
NPI:1962868158
Name:KEENAN, TRINITY (LCSW)
Entity type:Individual
Prefix:
First Name:TRINITY
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TRINITY
Other - Middle Name:
Other - Last Name:NICHOLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARBON
Mailing Address - State:WV
Mailing Address - Zip Code:25139-0131
Mailing Address - Country:US
Mailing Address - Phone:304-553-9796
Mailing Address - Fax:
Practice Address - Street 1:900 WASHINGTON ST E # A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1766
Practice Address - Country:US
Practice Address - Phone:304-837-2243
Practice Address - Fax:304-510-4778
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVCP009431831041C0700X
WVDP009431831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical