Provider Demographics
NPI:1972971455
Name:O'KEEFE, BRIAN CHRISTOPHER
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 COMMONWEALTH AVE # 350
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1041
Mailing Address - Country:US
Mailing Address - Phone:781-690-3411
Mailing Address - Fax:
Practice Address - Street 1:1089 COMMONWEALTH AVE # 350
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1041
Practice Address - Country:US
Practice Address - Phone:617-419-0262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA1218131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program