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Individual

DR. ADELE LOGAN O'KEEFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
825 FAIRFAX AVE, SUITE 118, NORFOLK, VA 23507-1914
(757) 446-5955
(757) 446-5196
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5955
(757) 446-5196

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004782
VA
106H00000X
Marriage & Family Therapist
0717001214
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-086
TRICARE/CHAMPUS
VA
01
1447575715
VIRGINIA PREMIER HEALTH PLAN
VA
01
1447575717
OPTIMA BEHAVIORAL HEALTH
VA
05
1447575717
VA
01
454466
ANTHEM BEHAVIORAL HEALTH
VA
01
PAR
AETNA BEHAVIORAL HEALTH
VA
Enumeration date
03/30/2010
Last updated
05/15/2012
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