Individual provider Active NPI

Rachel Elizabeth Keely

  • Professional Counselor
  • Meadville, PA
National Provider Identifier
1053130187
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC017422 Issued in PA
Practice address
435 Chestnut St
Meadville, PA 16335-4404
Phone
(814) 807-0861
Fax
(814) 807-0863
NPI assigned
Oct 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC017422 PA Primary

Addresses

Primary practice location

435 Chestnut St
Meadville, PA 16335-4404

Mailing address

435 Chestnut St
Meadville, PA 16335-4404
Phone (814) 807-8071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250403000256 PA Practitioner - Mental Health Counselor 1355864018 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Parkside Psychological Associates CurrentSince Jan 16, 2025 Accepting new patients

Locations

2028 Filmore Ave
Erie, PA 16506
Phone (814) 807-0681

8406 Sharon Mercer Rd
Ste 101
Mercer, PA 16137
Phone (814) 807-0861

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1053130187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 CHESTNUT ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163354404",
            "telephone_number": "814-807-8071",
            "fax_number": "814-807-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 CHESTNUT ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163354404",
            "telephone_number": "814-807-0861",
            "fax_number": "814-807-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELY",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC017422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.