Look up the most recent NPI and PECOS records

Tara Keegan

Social Worker

Behavioral Health & Social Service Providers

4660 S Eastern Ave, #104a, Las Vegas, NV 89119-6137

PECOS Enrollment

Based on the most recent information from CMS, provider Tara Keegan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1578890919
Provider Type
Individual
Full Name
Keegan, Tara
Credential
MSW, LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
11/5/2009
Last Updated
3/20/2012

Contact Information

Practice Location

4660 S Eastern Ave, #104a, Las Vegas, NV 89119-6137

(702) 451-7542

(702) 450-4239

Mailing Location

12 Oak Ter, Suffern, NY 10901-5907

(914) 450-5771

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 44SC05500200 New York
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License 5439-S Nevada
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License INTERN-IC-569 Nevada

Tara Keegan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Reisdorf, Stephanie

Hicks, Taryn Danielle

Dustin, Matthew Scott

Nilo, Minerva

Yaz, Saul

Paxinos, Maria

Sulls, Monique Francine

Leo, Nannina

Kanoza, Kavita K.

Mc Medical Group Of Nevada, P.C