Individual provider Active NPI

Jennifer Frye Keefe, M.A.

  • Mental Health Counselor
  • Lake Geneva, WI
National Provider Identifier
1033453030
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1582-226 Issued in WI
Practice address
166 E Geneva SQ
Lake Geneva, WI 53147-9694
Phone
(262) 249-0830
Fax
(262) 249-0835
NPI assigned
Nov 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1582-226 WI Primary

Addresses

Primary practice location

166 E Geneva SQ
Lake Geneva, WI 53147-9694

Mailing address

166 E Geneva SQ
Lake Geneva, WI 53147-9694
Phone (262) 249-0830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1582-226WIMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1033453030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 E GENEVA SQ",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531479694",
            "telephone_number": "262-249-0830",
            "fax_number": "262-249-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E GENEVA SQ",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531479694",
            "telephone_number": "262-249-0830",
            "fax_number": "262-249-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFE",
        "first_name": "JENNIFER",
        "middle_name": "FRYE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1582-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.