Provider Demographics
NPI:1376173013
Name:KEENEN, HALEY ERIN (BCBA)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ERIN
Last Name:KEENEN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61174 GEARY DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2919
Mailing Address - Country:US
Mailing Address - Phone:281-825-9920
Mailing Address - Fax:
Practice Address - Street 1:2000 TOWER OAKS BLVD FL 5
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4282
Practice Address - Country:US
Practice Address - Phone:240-664-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-19-40463103K00000X
VA0133003605103K00000X
MDLBA1848103K00000X
TX3233103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst