MR. KEENAN P TYNER LCSW
NPI 1023347911
Social Worker - Clinical in Ukiah, CA

Active since December 23, 2009
2240 OLD RIVER RD, UKIAH, CA 95482(707) 467-5181 Get Directions Write a Review

NPPES record last updated: March 30, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 30, 2023, Mar 17, 2018, Feb 15, 2018 and 1 more (4 updates tracked since 2017).

About Mr. Keenan P Tyner Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEENAN P TYNER LCSW (NPI 1023347911) is an individual clinical provider in Ukiah, California, licensed in California (LCSW101659) and active in the NPI registry since December 2009.

NPPES Registry Identity

NPI1023347911
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KEENAN P TYNERCredential: LCSW
Location Address2240 OLD RIVER RDUkiah, CA 95482-6103
Mailing Address1124 W Standley StUkiah, CA 95482-4231 · (707) 272-5989
Sole ProprietorNo
Enumeration DateDecember 23, 2009
Last NPPES UpdateMarch 30, 20234 updates tracked since enumeration
NPPES CertifiedMarch 30, 2023
NPI 1023347911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses Licensed in CA · LCSW101659 Licensed in CA · 69833
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselorTaxonomy 101Y00000X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 69833 (CA)
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
2240 OLD RIVER RD, Ukiah, CA 95482

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
2240 OLD RIVER RD
UKIAH, CA 95482
Marriage & Family Therapist
2240 OLD RIVER RD
UKIAH, CA 95482
Psychologist (School)
2240 OLD RIVER RD
UKIAH, CA 95482
Local Education Agency (LEA)
2240 OLD RIVER RD
UKIAH, CA 95482
Clinic/Center (Public Health, State or Local)
2240 OLD RIVER RD
UKIAH, CA 95482

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keenan Tyner's NPI number?

The NPI number for Keenan Tyner is 1023347911. It was assigned to this individual provider in the NPPES registry on December 23, 2009.

Where is Keenan Tyner located?

Keenan Tyner practices at 2240 Old River Rd, Ukiah, CA 95482. The listed phone number is (707) 467-5181.

What is Keenan Tyner's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Keenan Tyner was last updated on March 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.