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Individual
MR. EDWARD JOHN KEAVENY
Active
Individual
MR. EDWARD JOHN KEAVENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
CA
106H00000X
Marriage & Family Therapist
Primary
52652
CA
106H00000X
Marriage & Family Therapist
59604
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
02/08/2008
Last updated
01/28/2013
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