Provider Demographics
NPI:1831391242
Name:KEEVIL, DAVID (PSYD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KEEVIL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 MAIN ST STE 305
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3302
Mailing Address - Country:US
Mailing Address - Phone:508-314-4570
Mailing Address - Fax:
Practice Address - Street 1:747 MAIN ST STE 305
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3302
Practice Address - Country:US
Practice Address - Phone:508-314-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7456103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7456OtherPSY.D MA LIC#