Individual provider Active NPI

Michelle Lynn Keaton, LCSW

  • Clinical Social Worker
  • Lakeland, FL
National Provider Identifier
1053501544
Registry record updated Jan 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9618 Issued in FL
Practice address
257 Glenridge Loop N
Lakeland, FL 33809-1556
Phone
(863) 341-9670
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW9618 FL Primary
Social Worker 104100000X

Addresses

Primary practice location

257 Glenridge Loop N
Lakeland, FL 33809-1556

Mailing address

257 Glenridge Loop N
Lakeland, FL 33809-1556
Phone (863) 944-5100

Other practice location 1

905 S Missouri Ave
Lakeland, FL 33803-1033
Phone (863) 341-9670

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW9618FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
LCSW FL LLC Clinical CurrentSince Oct 5, 2025 Accepting new patients

Locations

905 S Missouri Ave
Lakeland, FL 33803
Phone (863) 331-9993

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": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769299200000",
    "number": "1053501544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 GLENRIDGE LOOP N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338091556",
            "telephone_number": "863-944-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 GLENRIDGE LOOP N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338091556",
            "telephone_number": "863-341-9670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 S Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338031033",
            "country_code": "US",
            "telephone_number": "863-341-9670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEATON",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2026-01-25",
        "certification_date": "2026-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9618",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2026; 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.