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THERESA A KEANE LCSW-R
NPI 1104382969
Social Worker - Clinical in Smithtown, NY

Active since February 18, 2019Opted out of Medicare · through Oct 18, 2026
285 MIDDLE COUNTRY RD # LL5, SMITHTOWN, NY 11787(631) 724-0600 Get Directions Write a Review

NPPES record last updated: February 18, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Theresa A Keane Lcsw-r NPPES

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

THERESA A KEANE LCSW-R (NPI 1104382969) is an individual clinical provider in Smithtown, New York, licensed in New York (RO52037-1) and active in the NPI registry since February 2019. She has opted out of Medicare through October 18, 2026.

NPPES Registry Identity

NPI1104382969
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameTHERESA A KEANECredential: LCSW-R
Location Address285 MIDDLE COUNTRY RD # LL5Smithtown, NY 11787-2978
Mailing Address285 Middle Country Rd # Ll5Smithtown, NY 11787-2978 · (631) 724-0600
Phone(631) 724-0600
Sole ProprietorYes
Enumeration DateFebruary 18, 2019
✔ NPI 1104382969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · RO52037-1
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.
285 MIDDLE COUNTRY RD # LL5, Smithtown, NY 11787
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Theresa A Keane Lcsw-r has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 18, 2024 through October 18, 2026.

Opt-Out Effective DateOctober 18, 2024
Opt-Out In Effect ThroughOctober 18, 2026Opt-out affidavits renew automatically every two years unless cancelled

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 Theresa Keane's NPI number?

The NPI number for Theresa Keane is 1104382969. It was assigned to this individual provider in the NPPES registry on February 18, 2019.

Where is Theresa Keane located?

Theresa Keane practices at 285 Middle Country Rd # Ll5, Smithtown, NY 11787. The listed phone number is (631) 724-0600.

What is Theresa Keane's specialty?

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

Is Theresa Keane enrolled in Medicare?

No. Theresa Keane has opted out of Medicare through October 18, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Theresa Keane was last updated on February 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.